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1. Most Significant Fall?

This is a question from my EMT-B class.

Which of the following patients has experienced the MOST significant fall?

(A) A 59 patient who fell 14
(B) A 48 patient who fell 13
(C) A 46 patient who fell 13 (Correct answer on quiz)
(D) A 50 patient who fell 13

I answered (A) because the distance you fall is more significant than your height. Here is a quote directly from the first sentence about Falls in our Orange Book: The injury potential of a fall is related to the height from which the patient fell".

Can any of you explain why I got this wrong?

Thanks.

2. I'm not sure, as I'm not an EMT but in the FA Squad, that for falls, it's about a ratio of height to distance fallen.

A 6 foot patient falling 6 feet isn't as bad as a 3 foot patient falling 6 feet. The first patient fell their height, whereas the 2nd patient fell 2 times their height, which would be more significant to that person.

And that methodology would line up with the correct answer on your quiz.

I'm not 100% but that's my interpretation of it.

3. I wonder if they calculated the entire height as the (height fell - height of the victim) in which case the total entire height for A would be 8'3", whereas for C it would be 8'6"

Just a guess - seems an odd way of calculating it as they're assuming the person lands feet-first and not on their face, back, belly, etc....

4. really!

5. Just a (semi-educated) guess & I don't have any books to reference at the moment, but I suspect it has to do with a "rule" about calculating fall severity in relation to a person's height (i.e. a fall greater than 3x pt. height = Trauma Center / Medivac Criteria). Although in my experience this rule is typically used to gage severity for pediatric Pt's. rather than adults but I guess the logic would still apply.

Therefore in your example answers dividing the fall distance by Pt height results in the following (all measurements converted to inches)

A) 168" Fall / 69" height = 2.434 "Severity Factor"
B) 156" / 56" = 2.786
C) 156" / 54" = 2.88
D) 156" / 60" = 2.6

This making C the most severe.

Edit To Add - st42stephenAFT beat me to the answer b/c I am slow at math *LOL*

6. Originally Posted by DanTheMan_01
This is a question from my EMT-B class.

Which of the following patients has experienced the MOST significant fall?

(A) A 5’9” patient who fell 14’
(B) A 4’8” patient who fell 13’
(C) A 4’6” patient who fell 13’ (Correct answer on quiz)
(D) A 5’0” patient who fell 13’

I answered (A) because the distance you fall is more significant than your height. Here is a quote directly from the first sentence about Falls in our Orange Book: “The injury potential of a fall is related to the height from which the patient fell".

Can any of you explain why I got this wrong?

Thanks.

Not even sure why it is a question. Am I really going to measure all this upon arrival at a scene, or am I going to start a simple triage and do a quick patient assessment to see who needs care first?

7. Originally Posted by DanTheMan_01
This is a question from my EMT-B class.

Which of the following patients has experienced the MOST significant fall?

(A) A 59 patient who fell 14
(B) A 48 patient who fell 13
(C) A 46 patient who fell 13 (Correct answer on quiz)
(D) A 50 patient who fell 13

I answered (A) because the distance you fall is more significant than your height. Here is a quote directly from the first sentence about Falls in our Orange Book: The injury potential of a fall is related to the height from which the patient fell".

Can any of you explain why I got this wrong?

Thanks.
As someone who has taken a lot of tests in both my EMS life and real life, I can say that is one of the most asinine test questions I have ever seen.

How about answer E - the one who, according to your assessment, has the most significant injuries.

8. Seems like a very silly question and rather pointless.

Originally Posted by LVFD301
Not even sure why it is a question. Am I really going to measure all this upon arrival at a scene, or am I going to start a simple triage and do a quick patient assessment to see who needs care first?
Agreed.

9. Originally Posted by LVFD301
Not even sure why it is a question. Am I really going to measure all this upon arrival at a scene, or am I going to start a simple triage and do a quick patient assessment to see who needs care first?
You & I both know the correct answer is based on severity of injury.
However when teaching the new EMS students to pass the Basic course material, the test questions are generated to mirror the asinine scenarios depicted by the national registry exam. You almost have to teach the "Book" answers , versus teaching how to do proper assessment and triage, in order for them to pass the final test.
Then once they have passed the exam we spend many months teaching them the street smarts to be a good EMT.

Having been in EMS since 1971,& ALS since 85, I took the written exam last year just to gauge how well the test questions were based on reality. I actually scored lower than some of the students in the basic class my wife was teaching. I got a 92.
They write the questions based on some unknown formula and many of them have several correct answers with an uncertainty of which is most correct according to what it taught in the book. The nat reg exam is similar to many of the written promotion exams given in the military, where there is one answer that completely out in left field, one that might be possible , and two that could be correct if you changed one word.
The problem for the student to solve is which wording is most correct.

10. Originally Posted by N2DFire
Just a (semi-educated) guess & I don't have any books to reference at the moment, but I suspect it has to do with a "rule" about calculating fall severity in relation to a person's height (i.e. a fall greater than 3x pt. height = Trauma Center / Medivac Criteria). Although in my experience this rule is typically used to gage severity for pediatric Pt's. rather than adults but I guess the logic would still apply.

Therefore in your example answers dividing the fall distance by Pt height results in the following (all measurements converted to inches)

A) 168" Fall / 69" height = 2.434 "Severity Factor"
B) 156" / 56" = 2.786
C) 156" / 54" = 2.88
D) 156" / 60" = 2.6

This making C the most severe.

Edit To Add - st42stephenAFT beat me to the answer b/c I am slow at math *LOL*

This sounds correct. I am going to do some research on it, but I think you have it. Thanks for the input guys. EMT-B is a tough class! This is by far the hardest class I have taken in my numerous years of college.

11. What a stupid question. I can just hear the dispatch now, "Fire department you are needed for a 5 foot 10 inch male that fell 12 feet..."

More important, how did they fall, and what did they hit? Someone falling 15 feet onto soft soil would be much less injured than someone than hit their head on concrete from 10 feet.

Or if they fell with a running chainsaw...

12. Originally Posted by DanTheMan_01
This is a question from my EMT-B class.

Which of the following patients has experienced the MOST significant fall?

(A) A 59 patient who fell 14
(B) A 48 patient who fell 13
(C) A 46 patient who fell 13 (Correct answer on quiz)
(D) A 50 patient who fell 13

I answered (A) because the distance you fall is more significant than your height. Here is a quote directly from the first sentence about Falls in our Orange Book: The injury potential of a fall is related to the height from which the patient fell".

Can any of you explain why I got this wrong?

Thanks.
Oh really? I didn't know that..Now I know..You're brilliant..

13. Any fall can be significant. One can trip and hit their head on a cocktail table... not much of a fall, but it cause a potentially fatal injury.

Treat the patient instead of trying to do the math....

14. Originally Posted by DeputyChiefGonzo
Any fall can be significant. One can trip and hit their head on a cocktail table... not much of a fall, but it cause a potentially fatal injury.

Treat the patient instead of trying to do the math....
Pretty much. Questions like this on a test are a prime example of mental masturbation that will never occur in reality.

"Sorry sir - we have to treat the individual with the more significant fall and a twisted ankle. I'm sure you and your broken back can wait a few minutes...."

15. or maybe they are trying to teach a little bit more on understanding the basis of the injuries?

You know, kind of like in the fire service where we teach more than simply shoot water at the flame...

16. Originally Posted by Bones42
or maybe they are trying to teach a little bit more on understanding the basis of the injuries?

You know, kind of like in the fire service where we teach more than simply shoot water at the flame...
Fire theory is different than medical triage. Even then, attacking fire is based upon current conditions, not theory found in a textbook - this is simply the same situation.

Plus, they left out a *huge* factor in this question. Mass. Force = Mass X Acceleration. So, the significant fall of someone weighing 200 pounds and 4'8" would be greater than someone who weighed 120 pounds and was 4'6" tall, assuming they fell from the same height (which was the exam question).

The question was pants-on-head retarded and has absolutely no reflection in reality.

17. This ratio of body height to fall height is important, but asking a question like this gives it too much emphasis. It's a piece of the puzzle, yes, but this exam will probably make too many EMT's think that it's the most important element.

The question should have clarified that all four patients landed on identical surfaces and show identical external injuries upon initial survey. THEN the ratio becomes kind of a tie-breaker, but even then this is splitting hairs. Or even, splitting hairs that have already been split.

C is the right answer, but the question is kinda pointless.

Ohhh, and as 105 just posted, weight is a big factor too!