NREMT Emergency Medical Technician (EMT) Cognitive ExamTraumaHard
A 40-year-old male presents with severe abdominal pain after being struck in the abdomen with a baseball bat. He is conscious and alert, but his abdomen is rigid and distended. His vital signs are BP 100/70 mmHg, HR 110 bpm, RR 22 bpm. What is the MOST immediate concern for this patient?
- ASpleen laceration
- BDiaphragmatic rupture
- CInternal hemorrhage
- DPeritonitis
Show answer & explanationAnswer & explanation
Correct answer: C. Internal hemorrhage
Blunt abdominal trauma with rigidity, distention, and signs of compensatory shock (tachycardia, mild hypotension) strongly suggests significant internal hemorrhage, which is a life-threatening emergency requiring rapid transport and definitive care.
Why the other options are wrong
- A. Spleen laceration is a common cause of internal hemorrhage after blunt trauma, but 'internal hemorrhage' is the broader and more immediate concern to address.
- B. Diaphragmatic rupture is possible but less immediately life-threatening than massive internal bleeding, and symptoms might be less overt initially.
- D. Peritonitis (inflammation of the peritoneal lining) can cause rigidity and pain, but it's often a later complication of organ rupture and leakage, and direct internal hemorrhage is the more immediate life threat from the initial impact.
Blunt Abdominal Trauma
Injury to the abdomen caused by a non-penetrating force, often leading to internal organ damage and hemorrhage.
- Common causes include MVCs, falls, assaults.
- Signs include pain, rigidity, distention, ecchymosis, signs of shock.
- Internal hemorrhage is a major concern.
Memory trick: Baseball Bat to Belly? Bleeding is Bad!