10 free AEMT practice questions: Burns, Musculoskeletal, and Special Trauma Populations

Assign the whole anterior trunk as eighteen percent because the patches all sit on it: The rule of nines gives the anterior trunk eighteen percent, and that works for a burn that covers the whole front of the trunk. These patches are small and scattered. Counting the full eighteen percent overestimates the burned area and throws off the fluid plan.

Count the blisters and allow one percent of surface area for every ten of them: Blisters are easy to count. Blister count has no set link to surface area. One blister can cover a whole hand, and ten can fit on a thumb. Standard burn assessment does not use any formula based on blister count.

Use the AEMT's own palm and fingers, which is the standard reference surface: Any adult's palm is about one percent of that same person's body. The proportion only works when the hand belongs to the body you are measuring. Your hand and the patient's hand are different sizes, so every patch comes out wrong by that difference.

Eighteen percent, using the adult head value of nine percent: Nine percent for the head is right for an adult. A child's head is a much bigger share of the body surface. Using nine percent here misses half of the head burn.

Thirty six percent, counting the head and the arm as eighteen percent each: Eighteen percent each sounds like it follows the pediatric change for both areas. Only the head and the legs change in a child. An arm is nine percent at every age.

Twenty two percent, averaging the adult and the pediatric head values: Averaging two charts can feel safe when you are not sure which one to use. The pediatric chart is a fixed set of numbers, not a range. An average gives a number that fits no patient.

In a vein of the lower leg, distal to the circumferential thigh burn: The lower leg was not burned, so it looks like clean, unburned skin. The lower leg sits below the burn that circles the thigh. The thigh tissue is about to swell, and a line in the lower leg is the one most likely to fail during transport.

Through the burned skin of the thigh, where the vein is largest and easiest: A vein under burned skin can stand out and look easy to hit. Going through burned skin brings infection into a wound that is already at high risk for it. The swelling under the burn also moves the vein away from the catheter.

In the external jugular vein, since both lower extremities are involved: The external jugular vein is something you look at when the arms and legs cannot be used. This patient has two completely unburned arms. A peripheral line in unburned arm skin is faster and lower risk.

The two breathing patients, since a pulseless patient is triaged expectant: Triaging a pulseless patient as expectant is correct at almost every other multiple-patient scene. Lightning is the named exception. Following the general rule here leaves behind the only patient whose outcome you can still change.

Whichever patient has the most visible burns, since those mark the strike: Visible burns can look like a measure of how much energy a patient took in. Lightning burns on the skin are often superficial. The damage that kills is electrical and on the inside, so burns are a poor guide to who goes first.

The apneic patient, once the two breathing patients are off the course: Moving the breathing patients off the course first looks organized. Both of them have strong radial pulses, and a few minutes will not change much for them. For the patient in a reversible arrest, every one of those minutes matters.

Apply the traction splint, since the femur is the greater threat to life: The femur fracture is the bigger threat to life of the two injuries, and treating the bigger threat first is good triage. Traction still sends the whole pull through the injured ankle. Treating the femur this way creates a second injury at the ankle.

Apply the traction splint with a gently reduced pull to protect the injured ankle: Turning down the pull sounds like a middle ground between two real problems. A contraindication is not a question of how much force you use. Any amount of traction still pulls on the injured ankle that the splint anchors against.

Splint the ankle separately first, then apply the traction splint as usual: Splinting the ankle first sounds careful and in the right order. A splint on the ankle does not take the ankle injury away. The traction splint still pulls against that ankle no matter what is wrapped around it.

Splint the leg exactly as found, since repositioning can worsen the injury: Splinting as found is the normal rule for an angulated fracture, because moving the bone ends adds bleeding and pain. The splint as found rule assumes the foot still has a pulse. This foot is pale, cool, and has no pulse at the ankle or on top of the foot. Splinting as found leaves the foot without blood flow for the whole transport.

Repeat realignment attempts until a pulse returns at the ankle or the foot: Trying again sounds reasonable when the first attempt did not bring the pulse back. Every extra attempt moves the bone ends through the fracture site again. Each pass tears more soft tissue and vessel wall without reliably getting blood flow back. Make one gentle attempt, then splint and transport.

Apply a traction splint to restore length and straighten the foot that way: A traction splint is the right tool for a shortened, angulated femur shaft fracture. This injury is below the knee. The traction splint anchors against the ankle and foot. The ankle and foot are the same part of the leg that has already lost its pulse, so a traction splint is contraindicated here.

Hold the fluid until the limb is free so that none of the volume is wasted: Waiting until the leg is free fits how most trauma care is done, and nothing looks wrong with this patient yet. The fluid has to be circulating before the potassium and acid reach the heart. Fluid started after the lift misses the moment the fluid was meant for.

Give fluid in small increments only if the blood pressure starts to drop: Giving fluid in small amounts based on the blood pressure is right for most bleeding patients. In crush syndrome, the threat is the potassium and acid that rush to the heart when the tractor comes up. The fluid has to be running before the lift to dilute that load. Waiting for a drop in blood pressure means the fluid may not be running when the tractor comes up.

Concentrate on splinting the leg so it is ready the moment it comes free: The leg will need a splint, so getting ready for the extrication is useful work. A splint does nothing about the potassium and acid that the lift is going to release. Splinting instead of starting the line leaves the patient without a line when the tractor comes up.

Treat it as a sprain, since there is no deformity and little swelling: No deformity and little swelling is how most sprains look. Children sprain far less often than adults do. In a child, the growth plate gives out before the ligament does.

Have the patient walk on it to see whether the pain is mechanical: Having the patient walk is a reasonable test for an adult ankle. Walking on a growth plate fracture can move the broken pieces out of place. A child can often put weight on a real fracture anyway, so putting a little weight on the ankle does not rule a fracture out.

Wrap it with an elastic bandage and let the family drive to the clinic: An elastic wrap and a clinic visit is often fine for a minor ankle injury. Here the ankle may have a fracture that is not splinted, and whoever carries the child to the car moves that fracture. The wrap and the drive also delay the imaging that decides the treatment.

As reassurance that the blood loss so far has been fairly minor: A blood pressure in the normal range looks like a sign the blood loss is small. Blood pressure is the last thing a child gives up. A normal reading tells you the child is still compensating, not that the blood loss is small.

As a normal reading, since children run lower pressures than adults do: Children do run lower blood pressures than adults. Calling this pressure normal skips over the pale, cool skin, the slow capillary refill, and the pulse of 148. Those findings show the child is working hard to keep the pressure there.

As evidence that the fast rate comes from pain rather than from bleeding: Pain does raise the heart rate, and a deformed forearm hurts. Pain does not make the skin pale and cool or slow the capillary refill to three seconds. Abdominal tenderness after a ten foot fall points to a more likely source, bleeding in the abdomen.

Record the mechanism as a simple trip and treat the injured wrist alone: Writing the fall up as a simple trip is fast, and a trip matches how the scene looks. A patient usually remembers tripping. Calling an unwitnessed fall a trip shuts down the most important question, the reason the patient fell.

Attribute the memory gap to age and concentrate fully on the injury: Some memory loss is common with age, and families often offer age as the explanation. A new memory gap covering exactly the moments around a fall is a finding, not the patient's baseline. Calling the gap normal can miss a syncopal episode.

Hold further assessment until the wrist is splinted, iced, and elevated: Finishing one task before starting the next feels organized, and the wrist is the injury you can see. The medical cause is the part of this call that can still kill the patient. Syncope or low glucose does not wait until the wrist is splinted, iced, and elevated.