New York State Emergency Medical Technician (EMT) Practice Exam

Which injury is MOST likely to be overlooked during initial assessment?

1. Fractured ribs

2. Chest contusion

3. Pneumothorax

4. Internal bleeding

The correct answer is: Pneumothorax

A pneumothorax may often be overlooked during the initial assessment due to its subtle onset and the fact that it can occur without obvious external signs. Patients with a pneumothorax can present with minimal symptoms at first, especially in the early stages, and may not exhibit significant distress or an altered level of consciousness. Initial assessments often focus on more apparent injuries or visible signs of trauma, such as fractures or contusions, which can draw attention away from internal issues like a pneumothorax. Furthermore, chest auscultation may not reveal the condition unless a complete respiratory assessment is performed. Therefore, the potential for the pneumothorax to present asymptomatically in its early stages makes it more likely to be missed in comparison to other injuries that may present with more overt signs or symptoms that would grab the attention of the provider during the initial examination.