Trauma Emergencies and Care Coursera Quiz Answers

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Week 01: Trauma Emergencies and Care Coursera Quiz Answers

Quiz 01: Course Disclaimer

Q1. Based on what you just read, what is highlighted as a feature of this particular course that will require you to be self aware:

There are graphic pictures and descriptions of injuries or injury patterns that are sometimes emotionally difficult to see or think about
It is important to practice your skills
There are skills checklists that are provided
The discussion boards are required activities;

Quiz 02 : Introduction and Kinetics of Trauma Assessment

Q1. You are dispatched to a call of bicycle hit by a car. It’s a warm, busy, weekend day and the call occurs downtown.

As you are driving to the call and thinking about your approach what is your first priority?
10 minute scene time: think about rapid scene and patient evaluation
Spinal immobilization: Don’t miss a cervical spine injury
Scene safety: Think about how you will control your scene with traffic and people passing by
The golden period for trauma: if you have a sick trauma patient get them to the trauma center quickly

Q2.

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You arrive on scene and find the above situation. The patient is found just to the right of the bicycle and car. She is helmeted and lying still in the street. Per bystanders the bicyclist was riding straight and the car turned into her resulting a head-on type collision.

When considering the kinetic energy in the car compared to the bicycle and bicyclist, which of the following are true?

This is an example of penetrating trauma;
If the car and the bike are going the same speed, the mass of the car will result in the car having greater kinetic energy
The object in motion will stay in motion
If the car was stopped and it’s velocity was zero prior to the accident it would still have a high kinetic energy

Q3. Look at the picture of your scene and what you know about the accident so far. What are your considerations based on this visual information? Choose all that apply

An auto vs. bike is going to be high risk for serious injuries
The likely mechanism of injury for this patient is blunt trauma
There is not evidence of damage to the hood or windshield so impacts for bicyclist must be minimal
There is only one impact associated with this crash and that is the patient/bike with the vehicle

Q4. All of the following are part of your responsibility when formulating your initial scene assessment (Choose all that apply):

Letting the police call for any additional medical resources that are needed
Identifying all patients involved
Controlling traffic around the scene
Evaluating the scene and formulating suspected mechanism of injury;

Q5. In this call, the driver of the car declines needing medical care or evaluation. There was only one rider on the bike. She is lying on the street and as you approach you note you have not yet seen her move.

As part of your initial priorities to stabilize this patient. What would be the first thing to address?

Airway compromise
C spine immobilization
Rapid transport to a trauma center
Active, significant hemorrhage

Q6. When you approach the patient once the scene is safe, you knee down by her and ask her name. She opens her eyes and says something about “going to lunch”. She doesn’t know what year it is but can talk to you. She has a radial pulse that is around 120. You do not see any active external bleeding.

What is your initial assessment and plan for this patient based on the above information?

Concerning for airway compromise. Prioritize ABC’s
Potentially sick trauma patient- gather more information at the scene
Stable trauma patient- complete your assessment on scene
Unstable trauma patient- complete a rapid trauma assessment, expedite transport;

Q7. By now you should have already known what ABC stands for. In this course we have added D and E. What do D and E stands for

Decontaminate and Disability but E stands for Evacuation⁶ or Evacuation and Evaluation. ⁷

Q8. You have identified your patient as a sick trauma patient and now want to make sure you maximize your patient’s outcomes and you are part of the team responsible for patient ongoing care and transport.

Which of the following are priorities while caring for this patient?

Appropriate, early c spine immobilization based on mechanism and altered mental status
Short scene time and rapid transport are very important
Prevent hypothermia
Perform a systematic secondary survey

Q9. You run a call on a patient who is 28 years old and fell 20 feet from a ladder and landed in some bushes mostly on his feet. The patient is alert, has a glascow coma score (GCS) of 15, has normal vital signs, and has pain isolated to his ankles and low back. He is moving all his extremities and doesn’t have evidence of trauma. Based on the 2011 trauma triage criteria set out by the Centers for Disease Control (CDC)

This patient must go to the highest level trauma center in the area
This patient does not meet any of the criteria in step one or two for needing a trauma center
Based on mechanism, this patient should go to a trauma center. This patient might not need to go to a level one trauma center
There are not any concerning features to this patient presentation and the patient can be transported anywhere

Q10. There is an explosion at a local factory and you are dispatched there as one of the many responding units. The patient you end up taking care of has a piece of metal in his left leg right in the middle of the thigh. He also is having a hard time hearing your questions because he says his hearing went bad at the time of the blast as well. Based on the three phases of blast injuries, the patient’s penetrating trauma to his leg is considered part of the __________ phase of blast injury while the suspected injury to his tympanic membrane is considered part of the _________ phase.

Please answer the fill in the blanks using this format: __________ , ___________

primary, secondary;

Week 02: Trauma Emergencies and Care Coursera Quiz Answers

Quiz 01: :Bleeding and Shock Assessment

Q1. Use the following scenario for questions 1-5:

You are posted in your ambulance on a Saturday afternoon in the city, waiting for your first call. The radio speaks as dispatch calls you: “Unit 101, We need you for an MCI.” The dispatcher goes on to explain that there has been a bridge that collapsed on the highway, and multiple vehicles were under the bridge and trapped. The command staff is on the way, and they need you to respond immediately as well. Your heart starts pounding as you put on your lights and sirens and start heading toward the location of the accident….

You are the first ambulance on the scene and there is one police officer there. You hear sirens in the background of the more resources on the way. What is your role at this time?

Stand back and wait for incident command to tell you what to do
Hop out of your rig and start seeing patients, looking for people to help and triaging
Recognize you have an MCI, assess the scene briefly from a safe distance and estimate how many additional resources may be needed;
Talk to the news truck that showed up and let them know what you know so far

Q2. Incident command is established and the incident commander asks you to start triaging patients. The scene has been secured and you walk up to one of the cars that is trapped and identify that there are three patients. Patient A is bleeding from his head, is talking but confused and is breathing on his own. Patient B Is a child in a car seat that is screaming and crying loudly, has a strong pulse and does not appear to have any trauma. Patient C has blood coming from their ears and nose, does not appear to be breathing spontaneously, and has no pulse. Your patients should be triaged as?

A: Red; B: Green; C: Red
A: Red; B: Green; C: Black
A: Red; B: Yellow; C: Red
A: Yellow; B: Green; C: Black

Q3. Another ambulance has arrived and is ready to transport patients. Incident command asks you to communicate, based on your triage, who needs to be transported. Your ambulance can take up to 3 patients at a time. Using the above patients, who should your transport on the first ambulance?

Patients A and B, C does not need to be transported
Patient A and C, the most critical at the scene
Patient A only
Patient C and start CPR immediately

Q4. You loaded up the first ambulance and are continuing your triage. You come across a patient who is awake and breathing and talking to you, and is screaming about pain in their right arm. You look and notice a near-complete amputation and an area that is squirting bright red blood. Your next move is?

Get on the radio and request another ambulance immediately, then move onto the next patient
Get the tourniquet off your utility belt and apply it to the arm that is bleeding, label the patient as red and continue to triage
Hold direct pressure as the next ambulance arrives
Label the patient as black and move on;

Q5. All of your patients have been triaged and transported. The chaos is over, and so is your shift. You go back to the garage and change into your regular clothes. You feel exhausted and emotional.

True or false- it is important to discuss the events of the day with someone, be it a therapist, a friend, or coworker to help decompress and process what you all went through.

True
False

Q6. You have a patient that you are transporting to a trauma center who has a gunshot wound to the abdomen. The patient has a heart rate of 120, a respiratory rate of 28, a systolic blood pressure of 130 and their skin is pale, cool, and clammy. What class of shock is this patient in, and what percentage of their blood have they lost?

Class II and 15-30%
Class III and 30-40%
Class I and <15%
Class IV and >40%

Q7. You are working a busy Saturday night shift and you get dispatched to a motor vehicle collision. Your patient is a 48 year old man who was the restrained driver of a car that hit a tree. His airbags did deploy.

He was able to get out of his own car, and walk over to your ambulance when you pull up on scene. He is complaining of abdominal pain. You sit him on the cot, and your partner gets vital signs while you start your assessment. Your partner tells you his vitals, which are: Heart rate 110, BP 86/44, respiratory rate 26. What are some indications that your patient may have internal bleeding? Choose all that apply;

His elevated heart rate
His mechanism of injury
His elevated respiratory rate
His low blood pressure

Q8. On your next call, you go to the scene of another motor vehicle collision. This time, your patient is a motorcyclist. He was wearing his helmet when someone ran a stop sign and collided with his motorcycle. His is lying on the ground, answering questions. He is unable to move his legs. His vital signs are: heart rate 98, BP 88/40, respiratory rate 24 and he is cool and clammy. What type of shock could this patient have? Choose all that apply

Septic shock
Anaphylactic shock
Hemorrhagic shock
Neurogenic shock

Q9. Regarding the patient scenario in question 8, what part of his presentation indicates you need to drive to a trauma center? Choose all that apply

His inability to move his legs
His insurance coverage
His mechanism of injury
His vital sign abnormalities

Q10. Your patient above gets to the hospital and they start giving him a blood transfusion. He is doing much better after this. You think back to when you first encountered the patient with his low blood pressure and pale, cool and clammy skin. What physiologic response is the body doing if this is hemorrhagic shock that would account for his skin exam?

Nothing, this is decompensated shock and the body is not responding
Shunting blood away from the distal aspects of the body to ensure perfusion of the vital organs
Releasing more neurochemicals to signal the brain to shut down
Activating the fight or flight response to dilate blood vessels to the more distal parts of the body;

Week 03: Trauma Emergencies and Care Coursera Quiz Answers

Quiz 01 : Soft Tissue Injury and Burns Assessment

Q1. You are going on a hike and you come across a hiker who fell and suffered this injury. You need to call for help, and the person on the other end of the phone asks for a description of the wound. Which of the following best describes this wound?

A large laceration to the mid inner thigh
An open fracture to the tibia and fibula with significant arterial bleeding
An avulsion injury to the mid inner thigh with exposed subcutaneous fat
An abrasion of the mid inner thigh

Q2. You are working at the firehouse when a patient comes up and knocks on your door asking for help. He states he was in a fight. There is no one else around, and the scene is safe. You do your rapid primary assessment and notice that he has a knife impaled firmly into his right axilla. How do you manage this injury?

Remove the knife and apply a tourniquet to the upper arm
Call for EMS and stabilize the knife in place using bulky gauze and a dressing
Stabilize the knife in place and advise the patient to seek care at the closest emergency department;
Remove the knife and apply direct pressure to the wound

Q3. Use the following scenario for questions 3-6.

You are called by the fire department to come help with a patient that has been involved in a car fire. He was driving along the highway and his cigarette fell into his car, catching the seats on fire. He drove into a field and was able to jump out of his car. The scene has been secured and is safe by the fire department. Your patient is sitting outside the car with a non-rebreather mask on and is talking to the fire department when you arrive.

What type of burn did this patient suffer from? Choose all that apply

Radiation burn
Thermal burn
Electrical burn
Inhalation burn

Q4. You have completed your primary survey and at this time are assessing the patients burns. He has burns to both of his arms from trying to put out the fire. The burns are scalded and black, and he is surprised that they do not seem to hurt him at all. The skin feels like leather. What is the classification of the depth of this burn?

Deep partial thickness
Superficial partial thickness
Superficial
Full thickness;

Q5. The patient has burns that completely cover both of his arms from his shoulders to his wrists, and wrap all the way around. He has a smaller burn, about the size of a basketball, to his chest, and some soot on his face. With the patient completely exposed, you do not identify any other burns at this time. Based on what you see, what is the estimated TBSA of burn?

15%
10%
20%
50%

Q6. What are the features of this case that would suggest you need to take this patient to a burn center? Choose all that apply

Suspected inhalation injury
The location in town the injury occurred
Burns that involve the feet, hands, face, or major joints
Full thickness burns

Q7. You are working at a fire station as part of the ambulance crew in the mountains. Your pager goes off, and you are notified that there has been a mountain climber that has fallen from his climb. You do not know much more, but know that you need to hike in to rescue the patient, so you pack your jump bag and start your trek in. As you are hiking in you get more information from dispatch. “Your patient is a 38 year old male who was rock climbing. He fell approximately 20 feet and had positive loss of consciousness. He is now awake and breathing, but is confused. His friend that is with him says he is pale and sweaty. He cannot walk because believes his legs are broken, and his friend says his upper leg does not look normal” You hike a little faster, because you know this patient sounds sick, and it sounds like multisystems trauma. Which feature of what you have heard so far could clue you in to this patient has a critical fracture? Choose all that apply;

The mechanism of his injury
His age
He is pale and sweaty
His upper leg “doesn’t look right”

Q8. You are working in the medical tent at a soccer tournament when one of the fans comes over to you and asks you to come evaluate a patient. The patient is a 17 year old boy who planted his foot then turned the other way, and states that he heard and felt a “pop” in his knee. You decide to splint his knee in order to get him transported to the hospital. What are the most important features of this splint? Choose all that apply

Evaluation CMS before and after splint application
Splint in a position of comfort
Immobilize the bones above and below the joint you are splinting
Try and put the knee back in an anatomical position before you splint it

Q9. You have a patient who is a 48 year old female who has a gunshot wound to her shin. It is a very small puncture wound, but she is having an excruciating amount of pain. You transport her to the hospital and then turn around to go on your next call. A few hours later, you come in to check on how she is doing. The doctor tells you that she went to the operating room because they were concerned for compartment syndrome. What are the physical exam findings they may have noticed to draw this conclusion?

Decreased mental status
Tachycardia, fever and hypotension
Pain, pulselessness, pallor, paresthesia, and paralysis
Bone fragments sticking out

Q10.It is a Sunday afternoon and dispatch tells you to go to a park, where there is a patient who has been bit by a dog. The scene is safe, and you assess your patient. You note that they have a very deep dog bite with lacerations and multiple puncture wounds to their forearm. The owner of the dog, and the dog, have since fled the scene and the patient does not know who they are. The patient asks your for a bandage and wants to continue playing in the park. What are some of the reasons your patient needs to be evaluated at the hospital that you need to advise your patient before they refuse transport? Choose all that apply

You do not know the dog’s immunization status, so the patient may need a rabies vaccine
The patient may need antibiotics to prevent infection
The patient may need an x-ray to make sure there is not a tooth left in the skin or a broken bone associated with the fracture
Bites are at a high risk for infection, so they need to be irrigated by medical professionals;

Week 04: Trauma Emergencies and Care Coursera Quiz Answers

Quiz 01: Trauma by System Assessment

Q1. You are working on the ambulance and you get dispatched to a call. It is 1 AM, and you know the bars are closing. Dispatch tells you that you are going to a “downed party outside the Watering Hole,” a well-known bar in the area. When you arrive, your patient is surrounding by other people, is yelling and you notice blood all over his face. He is angry about another person that hit him in the face. The police are on the scene and help with crowd control while you escort the patient to the back of your ambulance. What part of his presentation so far should concern you?

His is angry and may become violent
He has obvious facial trauma and may become an airway issue
He is possibly intoxicated and that can make him more unpredictable
The other person may still be trying to assault the patient because the police have not found him yet
All of the above

Q2. The same patient from the above scenario becomes unresponsive while you are transporting him to the hospital. You start from the top and repeat your primary survey, and your EMT student takes another set of vitals. You note that his heart rate is 46 bpm, his blood pressure is 202/160, and he is breathing very irregularly. You are concerned he may have a head injury. These vital signs:

Are known as Rebel’s triad, and may suggest intra-abdominal trauma
Indicate he has a subdural hematoma
Indicate the patient is likely intoxicated
Are known as Cushing’s reflex, and may suggest a severe head injury

Q3. Use the following scenario for questions 3-6.

It is a cold evening in the winter and you are resting comfortably at your post when the pager goes off. Dispatch alerts you to a motor vehicle collision that involves multiple vehicles. There is already an incident commander, and they are calling for all available ambulances to respond emergently. When you arrive, they tell you that you will be transporting a red patient to the hospital. They load him into your ambulance. They are able to tell you that he is a 50’s year old male, and was the unrestrained passenger in one of the cars. Most of the cars were travelling about 50mph, and this patient was found on the ground outside of the car. He is moaning and has multiple areas of obvious trauma.

What is the order of your priorities in this patient?

BSI, scene safety and application of a tourniquet
BSI, scene safety and start taking a history from the patient about the accident
BSI, scene safety, and look for bleeding
BSI, scene safety, direct your partner to hold cspine while you assess the patient’s responsiveness and begin your ABC’s

Q4. As you are assessing his breathing, you note that the patient has an open wound to their chest that is making a sucking sound. What is the treatment for this type of wound?

Packing with gauze and a tight bandage
Put your finger over the hole to stop the bleeding
All of the above are acceptable treatments
A three way occlusive dressing;

Q6. You are continuing your trauma assessment for the patient. When you are evaluating his lower extremities you notice an obvious deformity to his femur. You were focused on this and immediately evaluate it after your palpate his abdomen. What is your next move?

Immediately stop what you are doing and put the femur in a hare traction splint
Backtrack for a moment and assess the stability of the pelvis
Feel for a distal pulse
Splint the femur with a SAM splint and gauze

Q7. You get a set of vitals on your patient. You note that he is hypotensive to 60/40, and has a heart rate of 48 bpm. He is breathing 30 times per minute. What type of shock does he have?

Anaphylactic
Hypovolemic
Septic
Not enough information to determine
Neurogenic
Cardiogenic

Q7. You are working in the medical room of a baseball game when the field paramedics come rushing in with one of the players. They state that he was pitching and then the batter hit a line drive, and it struck the patient right in the chest. You assess for a pulse and do not feel one. You direct another EMT to start CPR and get the AED. At two minutes, the AED tells you a shock is advised. What happened to your patient?;

The ball knocked the wind out of him and he was unable to breath and arrested
The ball delivered a certain voltage of energy to his heart, which lead to a deadly arrhythmia
The ball broke his ribs and caused bilateral pneumothoraces
The ball broke his sternum and punctured his left ventricle

Q8. You are transporting a patient that was involved in a car accident and was wearing her seatbelt. She is complaining of neck pain, abdominal pain and chest pain, and tells you that she is 30 weeks pregnant. What is the safest way to transport this patien

On a backboard with c spine precautions, and the board tipped slightly to the patient’s left side
On their stomach
Sitting up in bed
On a backboard with c spine precautions

Q9. You are completing a neurologic exam on your trauma patient that was involved in a motorcycle crash. You note that the patient has a confusing exam: they cannot move either of their legs or feel pain. However, when you brush their legs lightly they are able to feel that normally. What type of injury is this most consistent with?

Cervical spine injury
Spinal column injury
Incomplete cord injury- anterior cord syndrome
Incomplete cord injury- Brown-Sequard syndrome

Q10. You are one of the transporting ambulances in a mass casualty incident where there are multiple blast injuries. They red patients have been transported, and they load a yellow and a green patient into your ambulance. You are evaluating your patient that has been triaged as yellow, and note that his left eye is partially hanging out of his eye socket. He is yelling, and you do not see any other injuries. What is the proper management of this patient’s eye injury?

Do nothing
Use a paper cup to cover the extruded eye and try and minimize manipulation of it
Try and put the eye back in the socket and cover it with gauze
Ask for another ambulance with ALS;

Review:

Based on our knowledge, we urge you to enroll in this course so you can pick up new skills from specialists. It will be worthwhile, we trust.