Chapter 28: Face & Neck Injuries

A 30-year-old female presents with redness, inflammation, and pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing:

Select one:

A. a detached retina.
B. conjunctivitis.
C. a corneal abrasion.
D. acute retinitis.

A 4-year-old female has a peanut lodged in the external auditory canal of her right ear.

You should:

Select one:

A. transport her to the emergency department.
B. thoroughly flush her ear with sterile saline.
C. remove the peanut with a cotton-tipped swab.
D. use tweezers to try to remove the object.

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face and several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious and alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, and respirations of 22 breaths/min with adequate tidal volume. You should:

Select one:

A. fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport.

B. fully immobilize her spine, irrigate her empty tooth sockets, attempt to locate the dislodged teeth, and transport.

C. apply oxygen via a nonrebreathing mask, suction her airway as needed, disregard the dislodged teeth, and transport.

D. assist ventilations with a BVM device, immobilize her spine, suction her oropharynx for 30 seconds, and transport.

A 6-year-old female was riding her bicycle and struck a clothesline with her throat. She is breathing, but with obvious difficulty. Your assessment reveals a crackling sensation in the soft tissues of her neck and facial cyanosis. In addition to the appropriate airway management, the intervention that will MOST likely improve her chance of survival is:

Select one:

A. careful monitoring her vital signs.
B. rapidly transporting her to the hospital.
C. quickly immobilizing her spinal column.
D. requesting a paramedic ambulance.

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain and blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should:

Select one:

A. irrigate both eyes continuously for 20 minutes with plain water.

B. flush both eyes with an alcohol-based solution and transport.

C. neutralize the acid chemical in his eye with an alkaline chemical.

D. mix baking soda with water and irrigate his eyes with the solution.

Bleeding from soft-tissue injuries to the face is MOST effectively controlled with:

Select one:

A. direct pressure using dry, sterile dressings.
B. pressure dressings and chemical ice packs.
C. ice packs and elevation of the patient’s head.
D. digital pressure to an adjacent pulse point.

Following blunt trauma to the face, a 21-year-old male complains of a severe headache and decreased ability to move his eyes. This patient’s clinical presentation is MOST consistent with:

Select one:

A. a blowout fracture.
B. optic vessel compression.
C. a ruptured eyeball.
D. a lacerated globe.

If your patient swallows blood following facial trauma, there is an increased risk of ________.

Select one:

A. altered LOC
B. GI trauma
C. hypotension
D. vomiting

Significant trauma to the face should increase the EMT’s index of suspicion for a(n):

Select one:

A. airway obstruction.
B. basilar skull fracture.
C. displaced mandible.
D. spinal column injury.

The Adam’s apple is:

Select one:

A. below the thyroid cartilage and forms the upper part of the trachea.

B. the lower part of the larynx that is formed by the cricoid cartilage.

C. the small indentation in between the thyroid and cricoid cartilages.

D. the upper part of the larynx that is formed by the thyroid cartilage.

The MOST significant complication associated with facial injuries is:

Select one:

A. damage to the eyes.
B. mandibular immobility.
C. cervical spine injury.
D. airway compromise.

The superficial temporal artery can be palpated:

Select one:

A. at the angle of the jaw.
B. just anterior to the tragus.
C. over the mastoid process.
D. slightly above the ear.

The upper jawbones are called the:

Select one:

A. maxillae.
B. zygoma.
C. mastoid.
D. mandible.

When a light is shone into the pupil:

Select one:

A. the opposite pupil should dilate.
B. both pupils should dilate together.
C. it should become smaller in size.
D. it should become larger in size.

When caring for a patient with an open facial injury, the EMT’s immediate priority should be to:

Select one:

A. manually stabilize the patient’s head.
B. wear gloves and facial protection.
C. consider the mechanism of injury.
D. closely assess the patient’s airway.

When performing a full-body scan, you should assess for ________.

Select one:

A. SAMPLE
B. DCAP-BTLS
C. OPQRST
D. AVPU

When transporting a patient with a facial injury, it is MOST important to be as descriptive as possible with the hospital regarding the patient’s injuries because:

Select one:

A. it saves time on repeat assessments at the hospital.
B. they must make arrangements for an ICU bed.
C. most patients with facial trauma will need surgery.
D. they may need to call a specialist to see the patient.

Which of the following statements regarding anterior nosebleeds is correct?

Select one:

A. They usually originate from the septum area and bleed slowly.

B. They cause blood to drain into the posterior pharynx.

C. They are usually caused by a fracture of the basilar skull.

D. They are usually severe and require aggressive treatment to control.

Which of the following statements regarding the vitreous humor is correct?

Select one:

A. It is a clear, watery fluid surrounding the eye and can be replaced if it is lost.

B. It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost.

C. It is a clear fluid that is produced by the lacrimal glands and cannot be replaced if it is lost.

D. It is a clear, watery fluid that is located in front of the lens and can be replaced if it is lost.

You are assessing a 59-year-old male and note that his pupils are unequal. He is conscious and alert. When obtaining his medical history, it is MOST pertinent to ask him if he:

Select one:

A. has a history of eye surgeries.
B. regularly sees a family physician.
C. noticed the change during a meal.
D. is allergic to any medications.

Which of the following statements regarding the “Adam’s apple” is FALSE?

Select one:

A. It is inferior to the cricoid cartilage.
B. It is formed by the thyroid cartilage.
C. It is the uppermost part of the larynx.
D. It is more prominent in men than in women.

The globe of the eye is also called the:

Select one:

A. lens.
B. orbit.
C. retina.
D. eyeball.

When a person is looking at an object up close, the pupils should:

Select one:

A. dilate.
B. constrict.
C. remain the same size.
D. dilate, and then constrict.

When caring for a chemical burn to the eye, the EMT should:

Select one:

A. prevent contamination of the opposite eye.
B. immediately cover the injured eye with a sterile dressing.
C. avoid irrigating the eye, as this may cause further injury.
D. irrigate both eyes simultaneously, even if only one eye is injured.

Which of the following signs is LEAST indicative of a head injury?

Select one:

A. Asymmetrical pupils
B. Pupillary constriction to bright light
C. Both eyes moving in opposite directions
D. Inability to look upward when instructed to