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EFMB 2022 Study Guide (1)
EFMB 2022 Study Guide (1)
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EFMB 2022 Study GuidePortable X-Ray Machine - ANS-The initial radiographic evaluation of a trauma patient begins
with supine Anterior-Posterior (AP) chest and pelvis radiographs taken in the trauma bay usually
with a(n)
False, Cervical Spine Radiographic Evaluations has largely been replaced by Computed
Tomography. - ANS-T/F: Computed Tomography scanning has been largely replaced by cervical
spine radiographic evaluations (CSRE) and should only be performed when CSRE is
unavailable
Role 3 - ANS-What is the lowest level of care equipped with a Computed Tomography Scanner?
Role 2 - ANS-What is the lowest level of care equipped with a portable X-Ray Machine?
Lead - ANS-Members of the trauma team should have ____ aprons and thyroid shields
available near the trauma bay for radiation safety.
6 Feet - ANS-Distance is also protective from radiation exposure. If feasible based on the
patient's condition, any personnel without lead shielding should move a short distance away
from the X-Ray unit. The recommended minimal distance is
Focused Abdominal Sonographic Assessment for Trauma - ANS-While the FAST scan has
been validated only in hemodynamically unstable blunt trauma patients, it has become a
standard tool in the trauma bay and Emergency Department (ED) in most trauma patients.
FAST stands for
98% - ANS-FAST in combat trauma has a sensitivity of only 56% and specifically of
FALSE (Correct Answer is Diagnostic Peritoneal Lavage or DPL) - ANS-T/F: The FAST exam
remains one of the most sensitive tests for hollow viscus injury and mesenteric injury.
TRUE - ANS-T/F: At the Role 3, properly trained providers including radiologist, surgeons, and
emergency physicians can perform and interpret FAST scans in the emergency department on
a handheld portable device.
Ultra Sound - ANS-A FAST examination is performed with a portable hand-held machine most
commonly using a standard 3-7 MHz curved array ___ probe
Intraperitoneal fluid - ANS-The standard FAST examination is focused on evaluating for the
presence of ___ in certain parts of the body.
,Liver and Kidney - ANS-When you perform a FAST examination on a patient, you inspect the
right upper quadrant. You are inspecting between which two organs?
Spleen and Kidney - ANS-When preforming a FAST examination on a patient, you inspect the
left upper quadrant. You are inspecting between which two organs?
Antecubital - ANS-An 18g ____ IV is typically desired for Computed Tomography IV access.
True - ANS-T/F: The goal of Computed Tomography contrast injection is to provide concurrent
solid organ enhancement, arterial enhancement, and pulmonary arterial.
False (We should use pediatric settings/doses/and contrast administration) - ANS-T/F: When
preforming Computed Tomography scan on a Military Working Dog, utilize a scanning protocol
based on the adult settings to include the doses of and rates of contrast administration.
True - ANS-T/F: All patients evacuated through casualty evacuation should have images sent
electronically ahead of time as well as have CD created to send with the patients as a backup.
False (MRI in the acute management of combat trauma has not been established) - ANS-T/F:
Magnetic Resonance Imaging is widely used in theater, as its utility in the acute management of
combat trauma was extensively established during Operation Enduring Freedom.
Role 3 - ANS-All trauma patients arriving at a Role ___ will receive proper and expeditious
radiologic screening of injuries.
False (Service members exposed to hazardous noise is impact noise or noise greater than
140dB are at high risk for acoustic trauma and subsequent hearing loss. - ANS-T/F: Patients
exposed to hazardous noise are only at risk for aural trauma.
Hearing Loss, Tinnitus (ringing in the ear), Aural Fullness, Recruitment (Ear Pain with Loud
Noise), Difficulty localizing sounds, Difficulty hearing in a noisy background, Vertigo - ANS-The
symptoms of acoustic trauma are:
Temporary or Permanent - ANS-Acoustic trauma may result in sensorineural hearing loss
(SNHL) that is either _____or____.
Tympanic Membrane - ANS-The ear, specifically the_____, is the most sensitive organ to
primary blast injury.
True - ANS-T/F: The smaller the size of the tympanic membrane perforation, the greater the
likelihood is of spontaneous closure.
8 weeks - ANS-The majority of tympanic membrane perforations that close spontaneously do so
within the first ___ after injury.
,House-Brackmann Grading - ANS-Acute management of intratemporal facial nerve injury is to
provide objective documentation of facial movement using the ___ scale.
False (Do not administer if contraindicated) - ANS-T/F: For significant facial pareses/paralyses,
early administration of steroids must always be provided regardless of contraindications.
Traumatic Brain Injury (TBI) following a blast injury, Otic capsule violating temporal bone
fractures, Secondary fractures of the inner ear, Vestibular nerves, Trauma induced
endolymphatic hydrops, Activation of subclinical superior semicircular canal dehiscence. -
ANS-Which inner ear abnormalities may cause vertigo?
be educated and directed to self-report for evaluation and possible treatment as soon as
practical. - ANS-All service members that develop symptoms consistent with noise trauma
(acute tinnitus, muffled hearing, fullness in the ear) should
Treat the patient with a fluoroquinolone and steroid containing topical antibiotic (e.g., 4 drops of
ciprofloxacin/dexamethasone or ofloxacin in the affected ear 3 times a day for 7 days.) Do not
irrigate the ear as it may provoke pain and vertigo - ANS-What is the best course of action if you
find debris in the external auditory canal or in the middle ear?
72 Hours - ANS-Hearing loss that persists ___ after acoustic trauma warrants a hearing test or
audiogram.
True - ANS-T/F: Vestibular trauma to the inner ear may manifest in vertigo.
have the exposure documented and should be evaluated by hearing testing as soon as
possible. - ANS-All patients with subjective hearing loss and tinnitus follow blast exposure
should
25dB - ANS-Patients with TTS greater than ___ losses in three consecutive frequencies should
be considered candidates for high dose oral and/or transtympanic steroid injections when not
otherwise contraindicated.
A comatose patient, symptomatic inhalation injury, deep facial burns, and burns over 40% Total
Body Surface Area (TBSA) - ANS-What are indications for endotracheal intubation during your
initial burn survey?
20% - ANS-Burn casualties with injuries greater than ___Total Body Surface Area (TBSA) are at
high risk for hypothermia.
False. You must immediately interrupt the burning process and address any life-threatening
bleeding, airway compromise, or tension pneumothorax as directed by Tactical Combat
Casualty Care guidelines. - ANS-T/F: When providing point of injury care to a burn patient, you
, must immediately debride blisters and cover burns with loose, moist gauze wraps or wet clean
sheet.
Nines - ANS-Calculate a burn patients initial burn size using the Rule of
Superficial (1st Degree) Burns - ANS-Which type of burn is not included in the estimation of
Total Body Surface Area (TBSA) used for fluid resuscitation?
Partial thickness burns (2nd Degree) - ANS-Which classification of burns are moist and sensate,
blister, and blanch?
Superficial burns (1st Degree) - ANS-Which classification of burns appear red, do not blister,
and blanch readily?
Full thickness burns (3rd Degree) - ANS-Which classification of burns appear leathery, dry,
non-blanching, are insensate and often contain thrombosed vessels?
10mL/hr x %TBSA. For patients weighing more than 80kg, add 100 mL/hr to IV fluid rate for
each 10kg >80kg. - ANS-What is the Rule of 10s burn resuscitation equation?
3 - ANS-For children suffering burn injuries, ____xTBSAxBody weight in kg gives the volume for
the first 24 hrs of fluid resuscitation.
False, Lactated Ringers (LR's), PlasmaLyte A™ (Baxter International, Deerfield, II) or other
isotonic solution is the preferred resuscitation fluid. - ANS-T/F: A hypotonic solution is the
preferred resuscitation fluid for a burn patient?
True - ANS-T/F Both under- and over- fluid resuscitation of burn patients can result in serious
morbidity and even mortality; patients who receive over 250 mL/kg in the first 24 hours are at
increased risk for severe complications including acute respiratory distress syndrome and both
abdominal and extremity compartment syndromes.
albumin - ANS-At 8-12 hours post-burn, if the hourly IV fluid rate exceeds 1500 mL/hr or if the
projected 24 hr total fluid volume approaches 250 mL/kg, initiate 5% ___ infusion for an adult
burn patient
Voice change, Soot about the mouth and nares, Hypoxia, Shortness of breath - ANS-What are
clinical signs of inhalation injury?
USAIR Burn Center in San Antonio, Texas. - ANS-Definitive care of US service members
suffering from burn injuries is provided at?
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