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) __________. - >>>>portable x-ray machine T/F: Computed Tomography scanning has been largely replaced by cervical spine radiographic evaluation (CSRE) and should only be performed when CSRE is unavailable. - >>>>False What is the lowest level of care equipped with a Computed Tomography scanner? - >>>>Role 3 What is the lowest level of care equipped with a portable x-ray machine? - >>>>Role 2 Members of the trauma team should have __________ aprons and thyroid shields available near the trauma bay for radiation safety. - >>>>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 __ - >>>>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 _________ - >>>>Focused Abdominal Sonographic Assessment for Trauma FAST in combat trauma has a sensitivity of only 56% and specificity of_. - >>>>98% T/F: The FAST exam remains the most sensitive test for hollow viscus injury and mesenteric injury. - >>>>FALSE T/F: At the Role 3, properly trained providers including radiologists, surgeons, and emergency physicians, can perform and interpret FAST scans in the emergency department on a hand held portable device. - >>>>TRUE A FAST examination is performed with a portable hand-held machine most commonly using a standard 3-7 MHz curved array _______ probe. - >>>>US The standard FAST examination is focused on evaluating for the presence of ______ in certain areas of the body. - >>>>free intraperitoneal fluid When performing a FAST examination on a patient, you inspect the right upper quadrant. You are inspecting between which two organs? - >>>>liver and kidney 14. When performing a FAST examination on a patient, you inspect the left upper quadrant. You are inspecting between which two organs? - >>>>spleen and kidney An 18g ______ IV is typically desired for Computed Tomography IV access. - >>>>antecubital T/F: The goal of Computed Tomography contrast injection is to provide concurrent solid organ enhancement, arterial enhancement, and pulmonary arterial. - >>>>TRUE T/F: When performing 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. - >>>>FALSEF T/F: All patients evacuated through casualty evacuation should have images sent electronically ahead of time as well as have a CD created to send with the patient as a backup. - >>>>TRUE T/F: Magnetic Resonance Imaging is widely used in theater, as its utility in the acute management of combat trauma was extensively establishment during Operation Enduring Freedom. - >>>>FALSE All trauma patients arriving at a Role _ will receive proper and expeditious radiologic screening of injuries. - >>>>3 T/F: Patients exposed to hazardous noise are only at risk for aural trauma. - >>>>FALSE The symptoms of acoustic trauma are: - >>>>- 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 ___. - >>>>temporary (temporary threshold shift, TTS) or permanent (permanent threshold shift, PTS) The ear, specifically the ______ , is the most sensitive organ to primary blast injury. - >>>>tympanic membrane (TM) T/F: The smaller the size of the tympanic membrane perforation, the greater the likelihood is of spontaneous closure. - >>>>TRUE The majority of tympanic membrane perforations that close spontaneously do so within the first _____ after injury. - >>>>8 weeks Acute management of intratemporal facial nerve injury is to provide objective documentation of facial movement using the ______ scale. - >>>>House-Brackmann grading T/F: For significant facial pareses/paralyses, early administration of steroids must always be provided regardless of contraindications. - >>>>FALSE Which inner ear abnormalities may cause vertigo? - >>>>- otic capsule violating temporal bone fractures - secondary infections of the inner ear or 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: - >>>>be educated and directed to self-report for evaluation and possible treatment as soon as practicable What is the best course of action if you find debris in the external auditory canal or in the middle ear? - >>>>Treat the patient with a fluoroquinolone and steroid containing topical antibiotic (e.g., four (4) drops of ciprofloxacin/dexamethasone or ofloxacin in the affected ear three (3) times a day for seven (7) days). Hearing loss that persists _ hours after acoustic trauma warrants a hearing test or audiogram. - >>>>72 T/F: Vestibular trauma to the inner ear may manifest in vertigo. - >>>>TRUE All patients with subjective hearing loss and tinnitus following blast exposure should: - >>>>- have the exposure documented - 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. - >>>>25 dB What are indications for endotracheal intubation during your initial burn survey? - >>>>- comatose patient - symptomatic inhalation injury - deep facial burns