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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 42-year-old man has called 911 because of severe back pain. He informs you that his back pain is related to a recent fracture of his coccyx. Based on this information, where should the EMT expect the patient to be complaining of pain?
2. 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:
3. 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?
4. Which sign or symptom best indicates the patient has experienced a spinal cord injury to the thoracic spine?
5. While transporting a 38-year-old female who fell from a second-story window, you note that she is becoming confused and her pulse rate is increasing. Additionally, her blood pressure has dropped and her skin is now cool and clammy. Based on these assessment findings, you would recognize:
6. An Emergency Medical Responder reports that a male patient, who was injured while playing football, has bruising to the lumbar region of the body. Based on this statement, the EMT should expect to find bruising in which area?
7. A patient is being extricated from a car using a short vest-type device. After the patient has been extricated, the EMT should:
8. Which statement is most accurate concerning spine motion restriction of an ambulatory patient?
9. Prior to the revisions in prehospital spinal assessment and care, the primary criterion for determining the need for spine motion restriction was:
10. You have arrived at the scene of a shooting where a middle-aged male sustained a single gunshot wound to the abdomen. As you approach the patient, you note that he is sitting up and attempting to talk with the police officers while holding a blood-soaked towel over the left upper quadrant of his abdomen. Once you get beside the patient, you realize he is speaking in a different language that neither you nor the officers understand. Your initial action in caring for this patient is to:
11. A patient was struck in the back by a heavy piece of wood that was being bent to make a form for a concrete arch. He is responsive, but cannot feel or move his legs. He has bruising to his back and is incontinent of urine. The skin below the injury site is red and warm. As a knowledgeable EMT, you should realize that:
12. 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?
13. 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?
14. 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?
15. 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?
16. A male driver was ejected from his vehicle after it rolled several times at a high rate of speed. As you approach the patient, you note that he is unresponsive and struggling to breathe. He also has a laceration to the left side of his face and multiple contusions to his legs. After assigning another EMT to take manual cervical spine motion restriction, what should you do?
17. A patient who was involved in a diving accident is found with his head positioned so that his left cheek is touching his left shoulder. He states that he has severe pain in his neck and it hurts to move his head. He denies numbness, tingling, or decreased strength in his arms or legs. What is the EMT's best course of action?
18. 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?
19. As you approach a motorcyclist who was thrown from his bike, you hear him saying that he cannot feel or move his legs. You note obvious deformity to both femurs as well as to his left wrist and forearm. Emergency Medical Responders are holding manual cervical spine motion restriction and have already assessed the PMS in the extremities. Given this information, which assessment should be done next?
20. Which statement is most accurate regarding the processes needed for a patient to clench the hand into a fist?
21. Which statement about the care and treatment of a patient with a spinal injury in the prehospital setting is true?
22. Which statement shows that the EMTs are correctly using a vest-type device while removing a patient from an entrapped vehicle location?
23. 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?
24. When applying a cervical collar to a young boy who fell out of a tree, the EMT realizes the main purpose of the collar is to:
25. A patient who was injured in a motor vehicle collision has a separation of the rib and its associated spinal vertebrae. Based on the anatomy of the spine, where has this injury occurred?

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