You are treating a patient whose open chest wound has been sealed by EMTs on the scene before your arrival. During transport the patient becomes more dyspneic, tachycardic, and hypotensive. There are no breath sounds on the affected side, and the patient has JVD. Which of the following is the best action?
A) Reinforce the dressing with additional tape, using tincture of benzoin, if necessary, to improve the seal.
B) Perform a needle thoracostomy at the second intercostal space in the midclavicular line.
C) Perform a needle thoracostomy at the fourth intercostal space in the midaxillary line.
D) Remove the dressing and see if the patient's clinical status improves, then replace the dressing.
Question 2
Firefighters are extricating the driver of a small car that was struck broadside by a delivery truck at a moderate rate of speed. The patient was unrestrained, and the car sustained severe damage to the driver's side. As the man is pulled from the car, you note severe deformity to his left thigh area. Your primary assessment shows the patient to be responsive to painful stimuli, with an open airway and adequate breathing at 20 breaths per minute. His radial pulse is present but rapid at a rate of 124. After applying oxygen, the EMT should immediately:
A) examine the left leg.
B) check for a pedal pulse in the left foot.
C) conduct a rapid secondary assessment.
D) apply a traction splint to the left leg.
