Paramedic Exam EMT Flashcards

Which of the following patients is most in need of a rapid trauma assessment?

Answer: A young woman with a gunshot wound to the chest.

A rapid trauma assessment is performed on patients with significant mechanisms of injury or critical findings to quickly identify life-threatening conditions. A gunshot wound to the chest indicates a high-energy impact and potential for severe internal damage to vital organs, making it the most immediate and life-threatening scenario among the choices, thus requiring the most rapid assessment.

What is the first step to take when you start to size up a scene?

Answer: Do a Body Substance Isolation (BSI).

The very first step in sizing up a scene, even before determining scene safety or mechanism of injury, is to ensure personal safety through Body Substance Isolation (BSI). This involves putting on appropriate personal protective equipment (PPE) like gloves, masks, and eye protection to prevent exposure to bloodborne pathogens and other infectious materials. This proactive measure protects the rescuer before any patient contact or detailed assessment begins.

In treating a patient, which of the following should you do first?

Answer: Determine the patient's signs and symptoms.

In patient assessment, the immediate priority after ensuring scene safety and BSI is to determine the patient's chief complaint and identify any immediate life threats by assessing their signs and symptoms. This initial evaluation guides further assessment and intervention, as understanding what the patient is experiencing is crucial for effective treatment. Pertinent medical history, medications, and allergies are important but typically follow the initial assessment of the current problem.

You are evaluating a patient who is breathing, but only very slowly. What's the correct name for this type of breathing?

Answer: Bradynea

The medical prefix 'brady-' means slow, and '-pnea' refers to breathing. Therefore, bradynea (or bradypnea) correctly describes abnormally slow breathing. Dyspnea refers to difficulty breathing, tachypnea is abnormally rapid breathing, and apnea is the complete cessation of breathing.

On each call, each squad should make a minimum number of contacts with dispatch. Which number is this?

Answer: 6

Standard EMS protocols often dictate a minimum of six radio contacts with dispatch during a call to ensure continuous communication and coordination. These contacts typically include acknowledging the call, en route, on scene, en route to hospital, at hospital, and clear from call. This ensures dispatch is always aware of the squad's status and location and facilitates effective resource management.

Which of the following describes how a child with a mild airway blockage should be treated?

Answer: Immediately provide transportation to the hospital and do not agitate the child.

For a child with a mild airway blockage who is still able to breathe, cough, or speak, the priority is to avoid agitating them, which could worsen the obstruction. Rapid transport to a hospital is crucial, where medical professionals can manage the situation in a controlled environment. Interventions like abdominal thrusts or finger sweeps are reserved for severe or complete airway obstructions in conscious children.

A diabetic patient who is conscious but quite disoriented is being evaluated by you. You are unable to identify if the problem is hypoglycemia or hyperglycemia. What do you do?

Answer: Administer oral glucose.

When a conscious but disoriented diabetic patient's blood sugar status is unknown, it is safer to administer oral glucose. Hypoglycemia (low blood sugar) can rapidly become life-threatening and is quickly reversible with glucose, whereas hyperglycemia (high blood sugar) develops more slowly and oral glucose would not immediately worsen the patient's condition significantly. This approach prioritizes treating the more immediate and dangerous possibility.

What is the most critical requirement that must be fulfilled for an EMT to assist a patient with angina who wants to take their nitroglycerin?

Answer: The EMT must have medical control.

While specific conditions like systolic blood pressure above 100 mm Hg and sublingual administration are important considerations for nitroglycerin, the overarching and most critical requirement for an EMT to administer or assist with any medication is to have medical control. This means receiving explicit permission or following standing orders from a physician or medical director. Without medical control, an EMT cannot legally or ethically administer medication.

You are evaluating a patient who has recently suffered a stroke to see if advanced therapy will be beneficial. What must you identify as the crucial element?

Answer: When did the patient's symptoms begin?

For stroke patients, the most crucial element to identify for potential advanced therapies (like thrombolytics) is the exact time of symptom onset, often referred to as 'time last known well.' These therapies are highly time-sensitive and are only effective if administered within a narrow therapeutic window, typically within 3-4.5 hours of symptom onset. The presence of specific symptoms is important, but the timing is the critical determinant for treatment eligibility.

You are assessing a stroke patient to see if advanced therapy would be successful. What is the critical factor you need to determine?

Answer: Attempt to diagnose the cause of the problem.

When assessing a stroke patient for advanced therapy, it is critical to attempt to diagnose the cause of the problem, specifically differentiating between an ischemic stroke and a hemorrhagic stroke. Advanced therapies like thrombolytics are only indicated for ischemic strokes and are contraindicated in hemorrhagic strokes, as they could worsen bleeding. Therefore, determining the type of stroke is paramount for successful and safe treatment.

What is the third step in the initial assessment process?

Answer: Identify the patient's chief complaints or any life threatening conditions.

The initial assessment process typically follows a structured approach. After determining the patient's level of consciousness (often the first step) and assessing airway and breathing (second step), the third step is to quickly identify the patient's chief complaint and any immediate life-threatening conditions related to circulation or other critical systems. This helps prioritize interventions and guides the rest of the assessment.

Which of the following is NOT regarded as one of the signs and symptoms of the patient?

Answer: The patient's last oral intake

Signs and symptoms are observable indications or subjective feelings reported by the patient that relate to their current medical condition. Obstetrical conditions, behavioral issues, and environmental emergencies are categories of medical problems that present with specific signs and symptoms. The patient's last oral intake, while important for medical history (e.g., for diabetic emergencies or before surgery), is not itself a sign or symptom but rather a piece of historical information.

Which of the following DOES NOT make up the upper airway?

Answer: The carina

The upper airway consists of structures above the larynx, including the nasopharynx, oropharynx, and pharynx, which are responsible for warming, filtering, and humidifying air. The carina is the point where the trachea bifurcates into the left and right main bronchi, marking the beginning of the lower airway. Therefore, the carina is not part of the upper airway.

What flow rate ought a nasal cannula to have?

Answer: 1-6 LPM

A nasal cannula is used to deliver supplemental oxygen at low flow rates. The typical flow rate range for a nasal cannula is 1 to 6 liters per minute (LPM), providing an oxygen concentration of approximately 24% to 44%. Flow rates above 6 LPM can be uncomfortable for the patient and do not significantly increase the delivered oxygen concentration due to anatomical limitations.

What signs should you check to see if it's okay to enter a scene?

Answer: All of the above.

Before entering any scene, a paramedic must conduct a thorough scene size-up to ensure safety. This involves checking for all potential hazards, including environmental problems (unstable terrain, extreme weather), hazardous substances (spills, downed lines, broken glass), and human-related dangers (traffic, law enforcement, or other rescue personnel). Ensuring the safety of the rescuer, patient, and bystanders is paramount.

How much oxygen can a bag valve mask (BVM) provide?

Answer: 100 percent

When a bag-valve mask (BVM) is properly used with an oxygen reservoir and connected to a high-flow oxygen source (typically 15 LPM), it can deliver nearly 100% oxygen to the patient. This makes the BVM an essential tool for providing high-concentration oxygen to patients who are not breathing adequately or require ventilatory support.