Motorcycle RTC Scenario (ECA)

Question 1 of 15

1. Question

On arrival at a trauma scene and as the first emergency service there, what is your first priority?

Ensure scene safety for yourself and your crew

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Check the patient’s pulse

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Immediately move the patient from the road

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Ask the patient what happened

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Question 2 of 15

2. Question

The patient is lying on the road next to the motorbike. They are shouting in pain about their leg and wants to know what condition the bike is in. What is the most appropriate first action for the patients’ care?

Perform a primary survey

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Splint the leg before anything else

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Provide analgesia and make the patient more comfortable

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Tell the patient to calm down

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Question 3 of 15

3. Question

You start completing a primary survey and assess for any catastrophic haemorrhage. As you search the injured limb you note that his dark jeans are saturated in blood. You quickly cut off the jeans and locate an open fracture of the tibia and fibula. Frank red blood starts squirting from the wound site. What category of bleed would you class this as?

Catastrophic

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Significant

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Moderate

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Light

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Question 4 of 15

4. Question

You alert your colleague to the bleed and ask for the trauma kit while you apply pressure to stem the bleed. What first line treatment should you apply for a catastrophic haemorrhage from a limb?

Catastrophic tourniquet application

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Pressure dressings

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Pack the wound with haemostatic gauze

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Raise the injury site and place a dressing

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Question 5 of 15

5. Question

As you apply the tourniquet, the patient is screaming in pain. You explain that you need to apply the device to save his life. How tight should the tourniquet be applied?

Until the bleeding stops

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At a comfortable level for the patient

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Until you can’t turn it any more

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Until the limb turns pale

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Question 6 of 15

6. Question

You tighten the tourniquet to the point where the bleeding stops. The patient is in a lot of pain but you explain that the device is saving his life. You continue to quickly run through the primary survey. You can see the patient has a clear airway, but you have concerns there may be spinal trauma present. You see the helmet has been removed by a member of the public. Should it be always kept on until a Paramedic has assessed the patient?

False – there may be circumstances where it can be left on to help maintain C-spine, but where there are risks to airway, or further life saving assessment and treatment is required, safe removal can be employed

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True – the helmet must always be left on the patient until a Paramedic reviews C-spine, regardless of the setting

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Question 7 of 15

7. Question

You continue through your primary survey, A – Clear and patent, B – Bilateral air entry auscultated with no obvious trauma to the thoracic area, C – a rapid and weak radial pulse, with the patient starting to look pale and clammy. What concerns you with the poor circulatory overview?

Severe blood loss and hypovolaemia

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Increased adrenaline distribution and hypertension

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Poor ventilation and hypoxia

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Risk of infection and sepsis

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Question 8 of 15

8. Question

You suspect a high likelihood of severe bleeding and the patient going into shock. You’ve tourniqued the limb and stopped the external bleed. You’ve reviewed for any other possible external blood loss but cannot find any. You suspect internal haemorrhage, what device can be applied for management of some internal haemorrhage?

Pelvic binder

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Neck collar

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Leg splint

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Place the patient on a scoop stretcher

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Question 9 of 15

9. Question

Your colleague grabs a pelvic binder and assists you in placing it. What landmark should the binder be placed?

Greater trochanter

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Iliac crest

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Below the head of femur

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Directly center across the pelvis

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Question 10 of 15

10. Question

Fire service colleagues have arrived and are able to assist. You get one of them to maintain neck and C-spine control, while the others assist where able. Your colleague shouts out several observations: Respiratory rate 28, Heart rate 117, SpO2 94%, Blood pressure 83/41, Temperature 36.2.

In a major trauma patient, is oxygen administration always advised?

True

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False

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Question 11 of 15

11. Question

You place O2 on the patient and note they are starting to get a little quiet. You prepare extrication equipment and start to package the patient. Alongside the management you’ve already given, what further considerations should you try to manage within your scope of practice?

Hypothermia management

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Fluid administration

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IV access

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Co-Amoxiclav administration

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Question 12 of 15

12. Question

You remember that hypothermia can have detrimental effects on a trauma patient and comes under the trauma triad. What 2 other elements make up the triad?

Acidosis

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Coagulopathy

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Electrolyte imbalance

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Raised ICP

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Reduced platelet count

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Question 13 of 15

13. Question

During packaging for extrication, the patient becomes increasingly drowsy and slower to respond to questions. What is your most appropriate action within the ECA scope of practice?

Escalate urgency, reassess CABCDE, maintain airway and prepare for rapid transport

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They are probably tired from the incident, let them rest

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Remove the pelvic binder in case it is causing discomfort

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Sit the patient upright to try to keep them awake

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Question 14 of 15

14. Question

You are preparing to hand the patient over to the receiving Paramedic crew. What is the most effective structure to give a clear trauma handover?

A structured handover such as ATMIST

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A general chat about what happened

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Only handing over vital signs and symptoms

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Asking the Paramedic to start again with the patient

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Question 15 of 15

15. Question

You travel with the Paramedic to assist on route to hospital. They administer a drug called TXA. What are the actions of this drug?

It's an antifibrinolytic which helps prevents clots from breaking down

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It’s an analgesic which helps with pain management and patients’ comfort

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It’s a diuretic and helps get rid of unnecessary fluid from the body

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It’s an anti-platelet and stops platelets from dissipating

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Motorcycle RTC Scenario (ECA)

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