EFMB 2022 Study Guide Questions and
answers graded A+
The initial radiographic evaluation of a trauma patient begins with supine Anterior-
Posterior (AP) chest and pelvis radiographs taken in the trauma bay usually with a(n) -
answer Portable X-Ray Machine
T/F: Computed Tomography scanning has been largely replaced by cervical spine
radiographic evaluations (CSRE) and should only be performed when CSRE is
unavailable - answer False, Cervical Spine Radiographic Evaluations has largely
been replaced by Computed Tomography.
What is the lowest level of care equipped with a Computed Tomography Scanner? -
answer Role 3
What is the lowest level of care equipped with a portable X-Ray Machine? - answer
Role 2
Members of the trauma team should have ____ aprons and thyroid shields available
near the trauma bay for radiation safety. - answer Lead
Distance is also protective from radiation exposure. If feasible based on the patient's
condition, any personnel without lead shielding should move a short distance away from
the X-Ray unit. The recommended minimal distance is - answer 6 Feet
While the FAST scan has been validated only in hemodynamically unstable blunt
trauma patients, it has become a standard tool in the trauma bay and Emergency
Department (ED) in most trauma patients. FAST stands for - answer Focused
Abdominal Sonographic Assessment for Trauma
FAST in combat trauma has a sensitivity of only 56% and specifically of - answer
98%
T/F: The FAST exam remains one of the most sensitive tests for hollow viscus injury
and mesenteric injury. - answer FALSE (Correct Answer is Diagnostic Peritoneal
Lavage or DPL)
T/F: At the Role 3, properly trained providers including radiologist, surgeons, and
emergency physicians can perform and interpret FAST scans in the emergency
department on a handheld portable device. - answer TRUE
A FAST examination is performed with a portable hand-held machine most commonly
using a standard 3-7 MHz curved array ___ probe - answer Ultra Sound
,The standard FAST examination is focused on evaluating for the presence of ___ in
certain parts of the body. - answer Intraperitoneal fluid
When you perform a FAST examination on a patient, you inspect the right upper
quadrant. You are inspecting between which two organs? - answer Liver and Kidney
When preforming a FAST examination on a patient, you inspect the left upper quadrant.
You are inspecting between which two organs? - answer Spleen and Kidney
An 18g ____ IV is typically desired for Computed Tomography IV access. - answer
Antecubital
T/F: The goal of Computed Tomography contrast injection is to provide concurrent solid
organ enhancement, arterial enhancement, and pulmonary arterial. - answer True
T/F: When preforming Computed Tomography scan on a Military Working Dog, utilize a
scanning protocol based on the adult settings to include the doses of and rates of
contrast administration. - answer False (We should use pediatric settings/doses/and
contrast administration)
T/F: All patients evacuated through casualty evacuation should have images sent
electronically ahead of time as well as have CD created to send with the patients as a
backup. - answer True
T/F: Magnetic Resonance Imaging is widely used in theater, as its utility in the acute
management of combat trauma was extensively established during Operation Enduring
Freedom. - answer False (MRI in the acute management of combat trauma has not
been established)
All trauma patients arriving at a Role ___ will receive proper and expeditious radiologic
screening of injuries. - answer Role 3
T/F: Patients exposed to hazardous noise are only at risk for aural trauma. - answer
False (Service members exposed to hazardous noise is impact noise or noise greater
than 140dB are at high risk for acoustic trauma and subsequent hearing loss.
The symptoms of acoustic trauma are: - answer Hearing Loss, Tinnitus (ringing in
the ear), Aural Fullness, Recruitment (Ear Pain with Loud Noise), Difficulty localizing
sounds, Difficulty hearing in a noisy background, Vertigo
Acoustic trauma may result in sensorineural hearing loss (SNHL) that is either
_____or____. - answer Temporary or Permanent
The ear, specifically the_____, is the most sensitive organ to primary blast injury. -
answer Tympanic Membrane
,T/F: The smaller the size of the tympanic membrane perforation, the greater the
likelihood is of spontaneous closure. - answer True
The majority of tympanic membrane perforations that close spontaneously do so within
the first ___ after injury. - answer 8 weeks
Acute management of intratemporal facial nerve injury is to provide objective
documentation of facial movement using the ___ scale. - answer House-Brackmann
Grading
T/F: For significant facial pareses/paralyses, early administration of steroids must
always be provided regardless of contraindications. - answer False (Do not
administer if contraindicated)
Which inner ear abnormalities may cause vertigo? - answer Traumatic Brain Injury
(TBI) following a blast injury, Otic capsule violating temporal bone fractures, Secondary
fractures of the inner ear, Vestibular nerves, Trauma induced endolymphatic hydrops,
Activation of subclinical superior semicircular canal dehiscence.
All service members that develop symptoms consistent with noise trauma (acute
tinnitus, muffled hearing, fullness in the ear) should - answer be educated and
directed to self-report for evaluation and possible treatment as soon as practical.
What is the best course of action if you find debris in the external auditory canal or in
the middle ear? - answer Treat the patient with a fluoroquinolone and steroid
containing topical antibiotic (e.g., 4 drops of ciprofloxacin/dexamethasone or ofloxacin in
the affected ear 3 times a day for 7 days.) Do not irrigate the ear as it may provoke pain
and vertigo
Hearing loss that persists ___ after acoustic trauma warrants a hearing test or
audiogram. - answer 72 Hours
T/F: Vestibular trauma to the inner ear may manifest in vertigo. - answer True
All patients with subjective hearing loss and tinnitus follow blast exposure should -
answer have the exposure documented and should be evaluated by hearing testing
as soon as possible.
Patients with TTS greater than ___ losses in three consecutive frequencies should be
considered candidates for high dose oral and/or transtympanic steroid injections when
not otherwise contraindicated. - answer 25dB
What are indications for endotracheal intubation during your initial burn survey? -
answer A comatose patient, symptomatic inhalation injury, deep facial burns, and
burns over 40% Total Body Surface Area (TBSA)
, Burn casualties with injuries greater than ___Total Body Surface Area (TBSA) are at
high risk for hypothermia. - answer 20%
T/F: When providing point of injury care to a burn patient, you must immediately debride
blisters and cover burns with loose, moist gauze wraps or wet clean sheet. - answer
False. You must immediately interrupt the burning process and address any life-
threatening bleeding, airway compromise, or tension pneumothorax as directed by
Tactical Combat Casualty Care guidelines.
Calculate a burn patients initial burn size using the Rule of - answer Nines
Which type of burn is not included in the estimation of Total Body Surface Area (TBSA)
used for fluid resuscitation? - answer Superficial (1st Degree) Burns
Which classification of burns are moist and sensate, blister, and blanch? - answer
Partial thickness burns (2nd Degree)
Which classification of burns appear red, do not blister, and blanch readily? - answer
Superficial burns (1st Degree)
Which classification of burns appear leathery, dry, non-blanching, are insensate and
often contain thrombosed vessels? - answer Full thickness burns (3rd Degree)
What is the Rule of 10s burn resuscitation equation? - answer 10mL/hr x %TBSA.
For patients weighing more than 80kg, add 100 mL/hr to IV fluid rate for each 10kg
>80kg.
For children suffering burn injuries, ____xTBSAxBody weight in kg gives the volume for
the first 24 hrs of fluid resuscitation. - answer 3
T/F: A hypotonic solution is the preferred resuscitation fluid for a burn patient? - answer
False, Lactated Ringers (LR's), PlasmaLyte A™ (Baxter International, Deerfield, II) or
other isotonic solution is the preferred resuscitation fluid.
T/F Both under- and over- fluid resuscitation of burn patients can result in serious
morbidity and even mortality; patients who receive over 250 mL/kg in the first 24 hours
are at increased risk for severe complications including acute respiratory distress
syndrome and both abdominal and extremity compartment syndromes. - answer
True
At 8-12 hours post-burn, if the hourly IV fluid rate exceeds 1500 mL/hr or if the projected
24 hr total fluid volume approaches 250 mL/kg, initiate 5% ___ infusion for an adult burn
patient - answer albumin
