Emergency Medical Technician (EMT) Intermediate Practice Exam

Which potentially lethal chest injury is least likely to be detected during the primary assessment?

1. Pneumothorax

2. Pulmonary contusion

3. Hemothorax

4. Cardiac tamponade

The correct answer is: Pulmonary contusion

A pulmonary contusion can often be difficult to detect during the primary assessment due to its subtle presentation. Unlike other injuries listed, a pulmonary contusion involves damage to lung tissue, which may not produce immediate signs or symptoms. Patients may not exhibit obvious respiratory distress initially, and the effects of the injury might be more pronounced during secondary assessment or over time as symptoms develop, such as increasing difficulty in breathing or blood-tinged sputum. In contrast, conditions like pneumothorax, hemothorax, and cardiac tamponade typically present with more acute signs that are detectable during the primary assessment. For example, pneumothorax may cause decreased breath sounds on one side, hemothorax can lead to signs of hypovolemic shock or dullness upon percussion of the chest, and cardiac tamponade often manifests with muffled heart sounds, hypotension, and jugular venous distension. These conditions usually create immediate indicators that can alert EMTs and healthcare providers during the urgent assessment phase.