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Prehospital Emergency Care Practice Test: Handing Spinal Trauma and Spine Motion Restriction
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Emergency medical services (EMS) first aid for spinal trauma includes: Keeping the head in line with the neck Preventing twisting the head Maintaining an open airway Applying a cervical collar Securing the stretcher Minimizing movement Spinal motion restriction (SMR) is a technique used by Emergency Medical Services (EMS) to limit the movement of a patient's spine, especially when the patient may have sustained a spine injury. SMR involves stabilizing the head, neck, torso, and pelvis to protect the spinal cord from movement of potentially fractured or unstable bone elements. This... Show more
Prehospital Emergency Care Practice Test: Handing Spinal Trauma and Spine Motion Restriction
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25 Questions

1. A male patient fell 20 feet from a cliff to a trail below while hiking with his girlfriend. The primary assessment shows him to be confused, with an open airway and shallow breathing. His pulse is 72 beats/min and his blood pressure is 78/50 mmHg. The skin is warm and flushed. The patient has no motor ability or sensation in his legs. What is the most likely cause of this patient's presentation?
2. A patient is lying under a tree after being involved in a motor vehicle collision. She states that immediately after the crash, she felt okay, but now her legs are numb and tingling. She also has lower back discomfort. Which question is it most important for the EMT to ask next?
3. Which of the instructions from one EMT to another shows the correct application of a cervical collar?
4. While performing the primary assessment on a patient with an isolated spinal cord injury, you note that he is in severe respiratory distress and struggling to breathe. Where should you suspect the spinal cord injury has occurred?
5. A 25-year-old male jail inmate was pushed over the railing of a walkway 20 feet above the ground. He is unresponsive and has an open fracture of the left upper arm. How would you determine if the patient has sensation in his legs?
6. Which statement is most accurate regarding the processes needed for a patient to clench the hand into a fist?
7. Research by the American College of Surgeons Committee on Trauma has shown a higher death rate for patients who were immobilized to a backboard when:
8. At a scene where a vehicle was involved in a single-car accident, you find the driver walking around at the scene. As you approach, the driver states that he felt fine when he exited the vehicle but is now concerned that his legs feel like they are 'going to sleep.' What is your first step in treating the driver?
9. A minivan has struck a utility pole. The driver is unresponsive and has life-threatening injuries. Which option would be most appropriate when extricating the patient from the vehicle?
10. A young female driver, who was involved in a motor vehicle collision, complains of cervical pain resulting from a lateral-type mechanism of neck injury. Based on this information, which type of collision most likely took place?
11. You arrive on the scene of a motor vehicle collision. Walking toward you is the unrestrained driver of the vehicle that sustained moderate front-end damage. The patient complains of some back pain, but is walking around after the crash and does not appear to be suffering from any neurologic deficits. Although he answers your questions appropriately, he keeps asking you, 'What happened?' What is your initial action in caring for this patient?
12. A patient is being extricated from a car using a short vest-type device. After the patient has been extricated, the EMT should:
13. A patient complains of lower back pain after falling down five stairs. Assessment of the patient's cervical spine reveals no displacement, tenderness, or instability. The patient does state that each leg has feelings of 'electrical shocks' shooting through them. How should the EMT care for this patient?
14. Which statement about removing a helmet in the prehospital setting is true?
15. When it is necessary to secure a patient to a long spine board during a spine motion restriction process, which of these regions is typically secured last to the spine board?
16. In which area of the spinal column do the ribs originate?
17. You are maintaining manual cervical spine motion restriction for a patient who is being log rolled, transferred, and secured to a long backboard. At which point will you release the manual spine motion restriction hold?
18. A restrained driver was in a car that struck another car from behind at a low rate of speed. The driver has a bruise to her forehead and complains of tingling in her left leg. She is lying on the side of the road, and another EMT has established manual cervical spine motion restriction precautions. A quick scan of her as you approach indicates that the patient is in little to no distress. What should you do first?
19. Which statement about the care and treatment of a patient with a spinal injury in the prehospital setting is true?
20. Which statement shows that the EMTs are correctly using a vest-type device while removing a patient from an entrapped vehicle location?
21. A motorcyclist wearing a full helmet was thrown from his motorcycle after hitting a patch of oil on the road. The bike had been traveling at a high rate of speed. Manual spine motion restriction is being maintained by an off-duty EMT. The primary assessment reveals the patient to be responsive to painful stimuli and breathing rapidly with slight sonorous airway sounds. His radial pulse is weak and fast. As you quickly scan his body, you note deformity to the left femur and lower leg. Your immediate action should be to:
22. Which instruction would you provide to your team immediately after securing a patient with head, neck, and back pain to the long backboard with appropriate spine motion restriction equipment?
23. An injury to a hemisection of the spinal cord that disrupts the spinal tracts on only one side of the cord is:
24. An elderly patient fell down a flight of basement stairs and is found at the bottom by family members about 20 minutes later. Your assessment reveals that the patient cannot feel painful stimuli to his hips and legs, nor can he move his legs, but he can feel you lightly touching the skin of his legs. Which type of injury may this be?
25. You are securing a patient to the long backboard. Of the options listed, which has the elements of securing the patient in the correct order?

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