10 free AEMT practice questions: Trauma Assessment and Fluid Resuscitation

Splinting a deformed lower leg: Splinting genuinely reduces blood loss into the thigh and is the best non-drug pain control you carry, which makes it feel urgent. It is not on the list of work that earns scene time, and a splint applied en route does the same job without costing the patient minutes.

Establishing two large-bore intravenous lines: Two large-bore lines are the right plan for an unstable trauma patient, and candidates who know that reach for it here. Access is placed en route, not on scene, because fluid does not fix internal bleeding and the line will run just as well while the truck is moving.

Obtaining a complete set of baseline vital signs: A full set of vitals feels like something you owe the patient before you move, and documentation pressure pushes candidates toward it. Vitals belong in the reassessment cycle you run the whole way in, and the first set can be taken once you are rolling.

The soft abdomen makes a major internal bleed unlikely, so look elsewhere: A soft, non-tender abdomen feels like real evidence, and it is the finding candidates most want to trust. The abdomen gives no reliable early findings in trauma, so it can be soft while liters accumulate, and the pelvis in this patient is a large enough reservoir on its own.

Pelvic pain alone can drive a heart rate this high through catecholamine release: Pain does raise heart rate, and a crushed pelvis hurts enormously, so this reads as a reasonable explanation. Pale, cool skin and a weak radial pulse are the clamped-down circulation of blood loss, and pain alone does not produce that combination.

With no external bleeding, the weak pulse points to a primary cardiac problem: Looking for a cardiac cause when no blood is visible is a habit that serves you well on medical calls. Here the mechanism explains everything, and a tachycardia that is a compensatory response to blood loss is hypovolemic shock with an appropriate heart rate rather than a heart problem.

Finish the weight-based volume, then reassess the patient: Finishing a calculated volume feels like completing the treatment, and weight-based numbers invite that kind of thinking. The volume is divided into increments precisely so that the reassessment between them can stop you early, and stopping short is a deliberate decision driven by what you just heard.

Keep the infusion running and raise the oxygen concentration: Raising oxygen is a reasonable response to increased work of breathing, and it will help the saturation for a while. It treats the symptom while the cause keeps arriving through the line, and an older patient with a failing reserve will keep declining until the fluid slows.

Change the fluid to Lactated Ringer's and continue the infusion: Lactated Ringer's is closer to plasma than normal saline and many trauma systems prefer it for large volumes, which makes this sound like a refinement. Both are isotonic crystalloid and both will back up into the lungs the same way; the problem here is the volume, not the bag.

Improving perfusion; continue the current plan and reassess in five minutes: A heart rate moving from 160 toward a normal range looks like exactly what you were hoping to see, and that is what makes this the most dangerous reading of the situation. Pale skin that has not changed and breathing that has slowed say the child is worse, not better.

Rising intracranial pressure; elevate the head about 30 degrees: Bradycardia with a head strike is a real pattern worth knowing, and Cushing's changes do include a falling heart rate. Cushing's comes with a rising blood pressure, a widening pulse pressure, and irregular respirations, and in an injured child hypoxia is far and away the more common cause.

A vagal response to pain; reassess after splinting and analgesia: Pain can produce a vagal response, and a struck child certainly hurts. A vagal event is brief and self-correcting, and it does not come with slow, shallow breathing and unchanged skin color in a child who was tachycardic minutes ago.

Compensated shock, because the heart rate is still defending the pressure: A heart rate of 148 does show the child compensating hard, and compensated shock is the stage students expect in a child because children hold their pressure so long. Compensation being present and compensation being adequate are different things, and once the measured pressure falls below the age threshold the stage has changed.

Adequate perfusion, because a systolic near 80 is normal for a 6-year-old patient: A systolic in the high 70s looks normal against adult numbers, and candidates who have not learned the age formula default to adult thresholds. Children run their own thresholds, and 78 is below the 82 this child needs.

Not yet stageable, because one set of vital signs is not a trend: Trending vital signs is good practice and you should absolutely get a second set. The findings in front of you already meet the definition of the decompensated stage, and waiting for a trend before acting on 78 systolic with 4-second capillary refill costs a child time.

Catheter length matters more than lumen size, so the two sites flow alike: Length does affect flow, which is why this sounds like it has the physics right. Radius is the far stronger variable, so a wider, shorter catheter wins on both counts at once and the two sites do not flow anywhere near alike.

The smaller catheter is less likely to infiltrate under pressure infusion: Small catheters are gentler on a fragile vein, and infiltration is a real complication worth respecting. A well-seated 18 gauge in the antecubital fossa is not fragile, and choosing a catheter too small to resuscitate through trades a rare problem for a certain one.

Gauge affects medication delivery but has little effect on gravity flow: Route does matter for some medications, and candidates who think in terms of drug delivery reach for this. Gauge is precisely what governs gravity flow, and it is the reason resuscitation calls for an 18 gauge or larger rather than whatever goes in easiest.

The sensor has loosened and is sampling room air: Equipment failure is always worth checking and a loose sampling line really does drop the number, so this is a habit rather than an error. A dislodged sensor tends to drop the value abruptly and flatten the waveform rather than producing a steady ten-minute slide, and the rest of this patient's picture supports a real change.

Carbon dioxide production has fallen as the patient calms down: Metabolism is one of the three inputs, so naming it shows the right framework. A calmer patient does not drop carbon dioxide production by 11 mm Hg worth in ten minutes, and a pelvic injury patient whose number is sliding is far more likely to be losing blood than relaxing.

This is normal variation, and the steady pressure is the better guide: Trusting the blood pressure over a newer number is a common instinct, and the pressure here genuinely has not moved. Blood pressure is a late sign and capnography is an early one, so a steady pressure alongside a falling end-tidal value is exactly the combination that should worry you rather than reassure you.

Omit spinal motion restriction because the neck is not painful: Denying neck pain is meaningful only when the patient is in a position to notice it, and a deformed painful forearm is precisely what prevents that. The absence of a complaint here is not evidence of an absent injury.

Omit spinal motion restriction because the patient walked at the scene: Walking at the scene does not clear a spine, since patients with unstable fractures and even incomplete cord injuries walk. Ambulation is not one of the findings used to decide about spinal motion restriction.

Apply spinal motion restriction only if a deficit appears en route: Waiting for a deficit means waiting for the injury to become a cord injury before protecting against it. Spinal motion restriction is applied to prevent that transition, not to react to it.

Tighten the splint to limit the swelling in the calf: Tightening the splint adds external pressure to a compartment already above its own perfusion pressure. Constriction is what is being removed here, not increased.

Elevate the leg well above the level of the heart: Elevating above the heart reduces the arterial pressure reaching a compartment that is already barely winning against the swelling inside it. The limb is kept level with the heart instead, which preserves the perfusion gradient.

Apply ice packs over the calf and continue to monitor: Ice and continued monitoring treat this as ordinary fracture swelling and allow a time-critical ischemia to progress. Cold also causes vasoconstriction, which further reduces flow into a compartment that needs more, not less.

Establish two large-bore intravenous lines and begin an isotonic bolus first: Fluid replacement does not stop ongoing arterial blood loss; starting IV lines before controlling the visible, uncontrolled bleeding lets the patient continue to lose blood faster than any bolus can replace it.

Perform a detailed abdominal exam to locate the internal bleeding source first: A detailed abdominal exam does not stop bleeding and delays a life-threatening intervention that is already identifiable and actionable at the extremity.

Splint the forearm in a position of function to help slow the blood loss: Splinting does not apply direct circumferential pressure to an arterial bleed; bystander direct pressure has already failed to control this spurting wound, so a tourniquet is required, not immobilization.