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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 high school football player was hit from behind and now complains of severe back pain and numbness to his right leg. Manual spine motion restriction is being maintained by an assistant coach. The trainer has already removed the face mask from the helmet. Once at the patient's side, what should you do next?
2. A 43-year-old male fell from a roof and cannot move or feel his arms or legs. When assessing the patient, which sign would lead the EMT to suspect the patient is developing spinal shock?
3. A male patient experienced an injury that completely severed his spinal cord in the thoracic spine. Which presentation would be associated with this injury?
4. 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?
5. Which response shows that the EMT is correctly assessing motor function in the arms of a patient with a potential spine injury?
6. A patient has just been log rolled and positioned onto the long backboard. Which care measure should be performed next, assuming it was not previously completed?
7. In which area of the spinal column do the ribs originate?
8. 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?
9. Prior to the revisions in prehospital spinal assessment and care, the primary criterion for determining the need for spine motion restriction was:
10. 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?
11. 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:
12. 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?
13. A patient is being extricated from a car using a short vest-type device. After the patient has been extricated, the EMT should:
14. 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?
15. An elderly patient fell down a flight of stairs and now complains of neck and back pain as well as weakness to both legs. The primary assessment reveals no life threats to the airway, breathing, or circulation. Manual cervical spine motion restriction is being maintained. What should the EMT do next?
16. The EMT should recognize a possible spinal column injury with no spinal cord involvement when he discovers which assessment finding?
17. The 'EMS Management of Patients with Potential Spinal Injury' document published by the American College of Emergency Physicians in 2015 discusses which principle regarding the immobilization of patients?
18. 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?
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. 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?
21. 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?
22. The EMT is properly assessing for a spinal cord injury when she:
23. 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:
24. A patient complains of back pain and numbness to both legs after being thrown from a bicycle. When should the EMT first check the motor function, sensory function, and pulses in the legs of this patient?
25. 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:

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