Trauma Emergencies

5 free sample questions of the 50 in this topic. The full set is in the app.

1. Question 1

   Significant mechanisms of injury (high-risk MOI) in trauma include all EXCEPT:

   • A.Falls >20 ft (>3× patient's height for adults; >10 ft or >2–3× for kids)
   • B.Vehicle ejection, death of another occupant in same vehicle, intrusion >12 in
   • C.Pedestrian struck at >20 mph; motorcycle crash >20 mph
   • D.Tripping and falling forward to hands and knees at standing height in a young, healthy adult
   Show answer & explanation

   Answer: D. Tripping and falling forward to hands and knees at standing height in a young, healthy adult

   Significant MOI flags include long falls, ejection, death of co-occupant, major intrusion, pedestrian struck, high-speed MVC, motorcycle crash, penetrating trauma to torso/head/neck. A short trip-and-fall in a healthy adult is not high-MOI by itself.

   Source: National EMS Education Standards 2021 — Trauma > Mechanism of injury (EMT: F,F)

2. Question 2

   An open ('sucking') chest wound should be initially covered with a:

   • A.Bulky dry dressing taped on all four sides
   • B.Commercial vented chest seal (or improvised occlusive dressing taped on 3 sides as a flutter valve) — convert to vented or burp seal if signs of tension pneumothorax develop
   • C.Plain gauze without occlusion
   • D.Hemostatic dressing packed into the chest
   Show answer & explanation

   Answer: B. Commercial vented chest seal (or improvised occlusive dressing taped on 3 sides as a flutter valve) — convert to vented or burp seal if signs of tension pneumothorax develop

   Open pneumothorax: commercial vented chest seal preferred (or 3-sided occlusive dressing as a flutter valve historically). Watch for tension pneumothorax — if it develops, burp/remove the seal to release pressure.

   Source: National EMS Education Standards 2021 — Trauma > Chest trauma (EMT: F,F)

3. Question 3

   A flail chest is defined as:

   • A.A single rib fracture
   • B.Two or more adjacent ribs each fractured in two or more places — producing a free chest-wall segment that moves paradoxically with respiration
   • C.Any pneumothorax
   • D.Subcutaneous emphysema
   Show answer & explanation

   Answer: B. Two or more adjacent ribs each fractured in two or more places — producing a free chest-wall segment that moves paradoxically with respiration

   Flail chest: ≥2 adjacent ribs broken in ≥2 places each → free 'flail' segment moves paradoxically (in on inspiration, out on expiration). High-energy injury; underlying pulmonary contusion is the bigger problem. Support ventilation; consider CPAP/BVM.

   Source: National EMS Education Standards 2021 — Trauma > Chest trauma (EMT: F,F)

4. Question 4

   Pericardial tamponade is recognized by Beck's triad:

   • A.Hypertension, bradycardia, tachypnea
   • B.Hypotension, muffled heart sounds, JVD — caused by fluid (often blood in trauma) compressing the heart in the pericardial sac
   • C.Pleuritic pain, fever, productive cough
   • D.Cyanosis, sweating, pale skin
   Show answer & explanation

   Answer: B. Hypotension, muffled heart sounds, JVD — caused by fluid (often blood in trauma) compressing the heart in the pericardial sac

   Beck's triad of cardiac tamponade: hypotension + muffled heart sounds + JVD. Often associated with penetrating chest trauma. Time-critical — pericardiocentesis is definitive (ALS/hospital).

   Source: National EMS Education Standards 2021 — Trauma > Chest trauma (EMT: F,F)

5. Question 5

   Tension pneumothorax features all EXCEPT:

   • A.Severe respiratory distress and hypoxia
   • B.Unilateral absent/diminished breath sounds with hyperresonance
   • C.JVD, tracheal deviation (away from the affected side, often a late sign), hypotension
   • D.Equal bilateral breath sounds and normal vitals
   Show answer & explanation

   Answer: D. Equal bilateral breath sounds and normal vitals

   Classic tension pneumo: severe distress, unilateral absent breath sounds, hyperresonance, JVD, tracheal deviation (late), hypotension, shock. Equal sounds and normal vitals rule it out.

   Source: National EMS Education Standards 2021 — Trauma > Chest trauma (EMT: F,F)

45 more Trauma Emergencies questions are in the app, along with explanations and flashcards for every one.

OnScene is an independent study aid based on the NREMT EMT Examination Specifications (2023 Practice Analysis), the National EMS Education Standards 2021, the National EMS Scope of Practice Model 2019, and the 2025 AHA Guidelines for CPR and ECC. It is not affiliated with, endorsed by, or sponsored by the NREMT, NHTSA, the American Heart Association, or any other organization.