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, which is what pulls them 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 hard 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 that most begs to be trusted. 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 expected stage 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 without the age formula adult thresholds are the default. 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: Catheter length does influence flow, so this sounds physics-literate, but radius is the dominant variable by a much wider margin. The 18 gauge and 20 gauge in this question do not flow anywhere near alike, which is the whole reason the larger proximal catheter is worth the extra time.

The smaller catheter is less likely to infiltrate under pressure infusion: Smaller catheters do infiltrate less often in fragile, small distal veins, a real concern in elderly or chronically ill patients. A well-seated 18 gauge in the antecubital fossa is not fragile, and for this unstable trauma patient the certain problem of inadequate flow outweighs a rare infiltration risk.

Gauge affects medication delivery but has little effect on gravity flow: Gauge does affect how fast you can push medications, so this fact is true on its own terms. It answers a drug-delivery question instead of the one asked here, since gauge is exactly what governs gravity and pressure infusion flow rates for volume resuscitation.

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 a splint controls bleeding and stabilizes fractures, the usual fix for a swollen limb. Here the calf is already compressed by its own rising pressure, so more constriction narrows the flow the muscle needs and worsens the ischemia.

Elevate the leg well above the level of the heart: Elevating a swollen limb above the heart is standard for ordinary fracture edema, since it lowers venous pressure and helps fluid drain. Here the tense calf and pain on passive toe extension point to compartment syndrome, where arterial inflow is already losing to tissue pressure; raising the leg drops that inflow further and speeds muscle death.

Apply ice packs over the calf and continue to monitor: Ice and monitoring fit ordinary post-splint swelling, where cold calms inflammation and time settles it. Pain far beyond the injury and pain spiking on passive toe extension mark compartment syndrome instead, and ice's vasoconstriction only adds to tissue pressure that is already cutting off flow.

Establish two large-bore intravenous lines and begin an isotonic bolus first: Establishing IV access and starting a bolus is the correct step for hypovolemic shock, and BP 82/50 with pulse 128 signals shock, but the wound is still spurting blood beneath the shirt, meaning fluids would just be poured into an open circuit while hemorrhage continues. Sequence matters: stop the bleed first, then replace volume, not the reverse.

Perform a detailed abdominal exam to locate the internal bleeding source first: A rigid, diffusely tender abdomen is the classic sign of intra-abdominal hemorrhage, and locating it feels urgent. That injury cannot be controlled in the field regardless of exam findings, while the spurting forearm wound is immediately treatable now. Detailed exam answers where the internal bleeding is, not how to stop the bleeding you can actually control.

Splint the forearm in a position of function to help slow the blood loss: Splinting can slow bleeding from a closed fracture by limiting bone-end movement and reducing further vessel injury. This is a partially amputated forearm with active arterial spurting, an open wound that needs direct arterial occlusion, not immobilization. A splint is contained within, not a substitute for, the tourniquet already required.