Prehospital Emergency Care, 11e
(Mistovich et al.) Chapter 36 Multisystem
Trauma and Trauma in Special Patient
Populations
You are by the side of an 88-year-old male who fell. He has a hematoma to his forehead as well as
deformity to his left forearm. His daughter informs you that her father has severe dementia and she
cares for him at home. As you assess him, he continually screams out, "Mary, help me. I need help!" At
this time, which question is most appropriate to ask the daughter?
A) "Was Mary his wife?"
B) "Is this how he normally is?"
C) "Do you know what he means by this?"
D) "My mother suffers from dementia; it is a terrible disease, isn't it?"
B
An 83-year-old female fell down the basement stairs. Once at her side, she tells you that her left hip
hurts and rates it as 10/10. Since the patient is downstairs, you recognize the need for assistance in
extricating her from the residence. As you start the primary assessment, you note a dog at the top of the
stairs starts growling at you. At this time, what is your primary concern?
A) Airway
B) Pain
C) Need for additional help
D) Dog
D
A car swerved to miss a deer in the road and hit a utility pole at a low rate of speed. Damage to the car is
minimal, but the 82-year-old male passenger was not wearing a seat belt and hit his head on the
dashboard. He presents as confused and diaphoretic. His daughter, the driver, states that he has a history
of dementia, high blood pressure, and diabetes, as well as coronary artery disease. She adds that he took
his insulin about 2 hours ago. Which question to the daughter would be most important at this time?
A) "How far along is the dementia?"
B) "He seems sweaty. Was he feeling okay this morning?"
C) "Did he eat anything today?"
D) "Does he take medication for the high blood pressure?"
C
A 78-year-old male pedestrian was struck by a car at a convenience store. The patient is conscious but
confused, and has sustained multisystem trauma. What would represent the best sequence of care for
this patient?
A) Primary assessment, oxygen, secondary assessment, spine motion restriction precautions, and all
, other care en route to the hospital
B) Primary assessment, spine motion restriction, and all other care en route to the hospital
C) Primary assessment, oxygen, secondary assessment, and all other care en route to the hospital
D) Primary assessment, oxygen, secondary assessment, cervical collar, and all other care en route to the
hospital
A
A 62-year-old female with severe kyphosis fell and hit the back of her head, which is now oozing blood
from a small laceration. Family members state that she suddenly complained of a "very bad headache"
before collapsing to the kitchen floor. She has snoring respirations and cyanosis in the extremities. Which
intervention should you perform first?
A) Apply a cervical collar
B) Use a jaw-thrust maneuver
C) Start positive pressure ventilation
D) Cover the laceration
B
You are transporting an elderly female who fell in a nursing home and displays outward rotation of her
left leg. She has a lengthy medical history, including dementia. Currently, she is very quiet and receiving
oxygen through a nasal cannula at 6 liters per minute. She also is secured to a long spine board. During
your reassessment, you note her to be alert but confused, with slightly accelerated respirations and a
strong radial pulse. You also note that her SpO2 has dropped from 97% on scene to 91%. You should:
A) Perform a head-tilt, chin-lift maneuver
B) Request ALS assistance
C) Apply supplemental oxygen
D) Start positive pressure ventilation
C
An unresponsive 10-year-old male was struck by a car while riding his bike. He has blood on his face and
presents with snoring respirations. Respirations are approximately 10 breaths per minute, with cyanosis
noted to his extremities. Manual spine motion restriction to the neck is being held by Emergency
Medical Responders. What should you do next?
A) Perform a jaw-thrust maneuver
B) Start positive pressure ventilation
C) Suction the airway
D) Quickly assess for life-threatening injuries
A
An elderly female fell and is now very confused. You are having a problem getting her past medical
history. Her daughter states that she is typically alert and very well oriented. What is your next best
action?
A) Transport the patient without delay
B) Contact the patient's doctor for the history
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