Trauma Study Guide for the EMT Test

General Information

Many EMT calls require expertise in dealing with some sort of trauma. This study guide provides an outline of the topics you might see on the test. Take time to fully research each one in your EMT textbook to be fully informed on all terms and procedures. The EMT Cognitive Exam Test Plan is expected to have 14%-18% questions related to Trauma. The questions included are made up of 85% Adult and 15% Pediatric.

Trauma Basics

Trauma is defined as serious physical and/or emotional injury or damage. It can be a physical wound or injury to the body, as from an accident or act of violence. It can also be an emotional response to a terrible event like rape or natural disaster. Immediately after the event, shock and denial are typical.

Terms/Concepts to Know: trauma emergencies, medical emergencies

Energy and Trauma

Three concepts of energy relate to patient injuries, with special consideration given to the discipline of physics. The content of Newton’s Laws of Motion is fundamental knowledge that plays a key role in the EMT’s proficiency and competency with injured patients during the physical assessment.

Terms/Concepts to Know: kinetic energy, work energy, potential energy, Newton’s Laws of Motion, energy impacts on injury

Mechanism of Injury Profiles

An injury can occur in many ways. This can be thought of as the how, what, and where of an injury. You need to know all three of these as they pertain to every injury you treat.

Terms/Concepts to Know: mechanism of injury, significant and non-significant injury, multisystem injury

Blunt Trauma

Blunt trauma is one of the two categories of trauma. This type of trauma is noninvasive and does not break the skin barrier. However, it can often be more serious than it appears on the outside due to the potential for internal bleeding and/or organ involvement.

Terms/Concepts to Know: blunt and penetrating trauma, coup and contrecoup brain Injury, deceleration, mechanism of injury, signs, symptoms, and index of suspicion

Penetrating Trauma

Penetrating trauma is the second of the two categories of trauma. This type of trauma penetrates at the skin level as well as at various levels below the skin. Both external and internal wounds are evident in penetrating trauma.

Terms/Concepts to Know: cavitation, drag, projectiles, trajectory, mechanism of injury

Blast Injuries

Blast injury may occur in four ways: primary, secondary, tertiary, and quaternary. The type of injury differs based on the mechanism of occurrence. It is not uncommon for a patient to have more than one type of blast injury.

Terms/Concepts to Know: primary, secondary, tertiary, and quaternary blast trauma, arterial air embolism, pulmonary blast injuries, tympanic membrane

Multisystem Trauma

The type of trauma termed multisystem indicates injuries where more than one body system is impacted. When there are multiple systems impacted/injured, the patient can be in a life-threatening situation. These impacts create a high acuity level and may require extensive care from an interdisciplinary medical team.

Terms/Concepts to Know: golden principles, golden hour/period

Patient Assessment

The patient assessment is the act of identifying/collecting information to use in addressing the patient’s healthcare needs based on the situation. In the case of trauma, this process requires organized, thorough, and timely completion. Focus on identifying injuries through chief complaint, visual clues, vital signs, and symptoms in collaboration with the physical assessment.

Terms/Concepts to Know: components of the patient assessment, important/key assessment points specifically related to injury of the neck/throat, chest, head, and abdomen

Transport and Destination

It is vital for the EMT to have a working knowledge of the transportation resources and Trauma Center levels when handling injured patients. A major goal of the emergency medical system is to ensure safe, timely, quality, and efficient treatment for an injured patient in the prehospital phase. This includes travel in the most effective, efficient mode of transportation to the most appropriate level trauma center required based on the patient acuity.

Terms/Concepts to Know: classification system of Trauma Centers, revised trauma score (RTS), trauma score, Glasgow Coma Scale (GCS), scene time, platinum 10, types of transportation resources

Review of the Cardiovascular System

The cardiovascular system’s main job is to maintain adequate blood flow, pressure, and supply throughout the body. The word system is key, as there is more to it than the heart; the system also includes veins, capillaries, and arteries.

Terms/Concepts to Know: function and location of the heart, arteries and capillaries, the three parts of the cardiovascular system, aorta, venules, veins, and arterioles

Pathophysiology and Perfusion

The Merriam-Webster medical dictionary describes perfusion as “the pumping of fluid through an organ or tissues.” You need to understand the importance of adequate perfusion. Your knowledge needs to include the symptoms and disease processes that impact organs and systems when there is not adequate perfusion.

Terms/Concepts to Know: perfusion as it relates to blood flow, inadequate perfusion impact to critical organs and systems, time frames for death/damage to an organ or system without adequate perfusion

External Bleeding

It is critical to understand the characteristics and significance of external bleeding. In addition, knowledge of total blood volume and the body’s ability to handle acute and profuse blood loss is important.

Terms/Concepts to Know: hemorrhage, hypovolemic shock, hemophilia, vasoconstriction, coagulation, the characteristics and significance of external bleeding

Internal Bleeding

Internal bleeding is just that: bleeding inside, with no significant visible bleeding outside. This makes detection much more difficult. There are, however, physical signs and symptoms that are important to know for early detection and treatment. Understanding the nature of the illness, identifying signs and symptoms, and knowing the mechanism of injury (MOI) are key to providing appropriate care.

Terms/Concepts to Know: contusion, ecchymosis, hematuria, hematemesis, melena, signs and symptoms of internal bleeding in trauma and medical patients

Patient Assessment

Patient assessment is the act of identifying and collecting information that will be used to address the healthcare needs of the patient based on the situation. The assessment for a patient with external or internal bleeding must be organized, thorough, and timely. It must include: scene size-up, primary assessment, history, secondary assessment, and reassessment.

Terms/Concepts to Know: five components of the patient assessment, important/key assessment considerations that are specifically related to internal and external bleeding, AVPU, DCAP-BTLS

Emergency Care for External Bleeding

External bleeding can be as basic as an abrasion or as complicated as profuse bleeding. You need to know the standard precautions and the steps for care and control of general external bleeding, including bleeding from the ear, nose, and mouth.

Terms/Concepts to Know: use of standard precautions, common methods to control external bleeding, basic techniques to control bleeding, hemostatic agents, tourniquets, epistaxis

Emergency Care for Internal Bleeding

In most cases, internal bleeding requires hospital-based care and, often, surgery. You need to know the symptoms and appropriate steps in prehospital care, including procedures to prevent further damage from internal bleeding.

Terms/Concepts to Know: steps to identify and care for internal bleeding, pelvic binder, open book pelvic fracture