Practice Quiz

NREMT Paramedic Trauma Exam Prep

Category - Paramedic Trauma

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Upon arrival to the scene of a stabbing, you find a patient with a stab wound to the left chest, midclavicular, 4th intercostal space. The patient is in peri-arrest, hypotensive, with a rapid, thready pulse and jugular venous distension. The patient’s GCS score is 3.

You perform bilateral needle decompression, but there is no rush of air or improvement in patient’s condition. The patient no longer has a pulse and now presents in PEA.

Which of the following is suspected in assessing the patient?
  1. Cardiac rupture
  2. Diaphragmatic rupture
  3. Hemopneumothorax
  4. Pericardial tamponade
Explanation
Answer: D -Hypotension presenting with JVD and clear mechanism of traumatic injury is highly suspect for pericardial tamponade.

Consideration for a hemothorax, pneumothorax, or hemopneumothorax should be made and can be differentiated by considering location of penetrating trauma, presence of Beck’s triad and clinical suspicion. Cardiac rupture is almost entirely caused by blunt force trauma, particularly in MVAs.
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