Emergency Medical Technician (EMT) Trauma Practice Test

A 45-year-old male was stabbed in the left anterior chest. He is conscious, but restless. His skin is cool and clammy, his blood pressure is 90/60 mm Hg, his respirations are rapid and shallow, and his heart rate is 120 beats/min and weak. Further assessment reveals that his breath sounds are clear and equal bilaterally and his jugular veins are distended. In addition to giving him high-flow oxygen, you should:

1. cover the stab wound with an occlusive dressing, support ventilation as needed, and transport rapidly

2. perform a detailed physical exam at the scene to ensure that you locate and treat less obvious injuries

3. control the bleeding from the stab wound with a sterile porous dressing and reassess his vital signs

4. suspect that the patient has a tension pneumothorax and notify the trauma center as soon as possible

The correct answer is: cover the stab wound with an occlusive dressing, support ventilation as needed, and transport rapidly

In this scenario, the 45-year-old male who was stabbed in the left anterior chest is displaying signs of shock, such as cool and clammy skin, hypotension (blood pressure of 90/60 mm Hg), rapid and shallow respirations, weak rapid heart rate (120 beats/min), and distended jugular veins. These signs indicate a potentially life-threatening condition, such as cardiac tamponade or tension pneumothorax, that requires immediate intervention. The correct course of action is to cover the stab wound with an occlusive dressing to prevent air from entering the chest cavity, support ventilation as needed to ensure adequate oxygenation, and transport the patient rapidly to a trauma center for definitive care. Providing high-flow oxygen helps in maintaining oxygenation and perfusion to vital organs. Performing a detailed physical exam at the scene or controlling bleeding with a porous dressing are not the immediate priorities in this situation. The presence of distended jugular veins suggests a possible tension pneumothorax, which can quickly deteriorate and compromise the patient's breathing and circulation, underscoring the importance of rapid transport to a trauma center. Therefore, the most appropriate action in this scenario is to cover the stab wound with an occlusive dressing, support ventilation as needed, and transport the patient rapidly.