NYS EMT Exam Comprehensive Review

Your patient responds to your voice with incomprehensible murmurers. Using the AVPU scale, he is classifed as responsive to:

Verbal stimuli

Do vitals signs have to be taken on-scene in every situation?

No. Vitals should be taken enroute for patients idenitified as high priority for immediate transport for definitive care .

What does SAMPLE stand for?

Signs and symptoms, allergies, medications, past medical history, last meal, events lead to current state.

What forms of abuse are EMS providers mandated to report?

Child, Spouse, and Elder Abuse must be reported on the PCR/E-PCR and verbally at transfer of care. Child abuse must also be reported according to NYS Bureau of EMS Policy #02-01.

Does a PCR/E-PCR have to be completed when no patient contact is made?

Yes, even for stand-bys, calls where no patients are located, cancellations, and events.

What does HIPAA stand for?

Health Insurance Portability and Accountability Act of 1996.

When reporting responsiveness, EMS providers should use _______________ to avoid less clear descriptors.

AVPU

For a hypoglycemic patient, when is it appropriate to give oral glucose, juice, or non-diet soda?

If the patient is alert enough to sit unsupported, follow commands, and drink without assistance.

When is aspirin contraindicted for an MI patient?

Recent GI bleed and known allergy.

According to NYS BLS protocol, the administration of nitroglycerin for chest pain is indicated if the adult patient's BP is than _____mmHg.

120

According to NYS BLS protocol, a maximum of ____ total doses of nitroglycerin can be given without medical direction to adult chest pain patients.

3

When is it appropriate to actively rewarm frostbite in the field?

The patient does not need to walk further and there will be a transport greater than 30 minutes,

For a genrealized hypothermia patient, pulse checks should last at least _____ before CPR is started.

30-45 seconds

If severe hypothermia is present, can defibrillation be performed?

Give a mximum of three shocks, but withhold drugs.

Your patient acutely developed a high grade fever, has a muffled voice, stridor, and drooling. You should suspect:

Epiglottitis (bacterial)

Your patient has been ill for the last few days with coldlike symptoms, a barky cough, and a low grade fever. He woke at 3:00am with severe symptoms. You suspect:

Croup (viral)

Ideally, a BVM used for emergency situations should:

Be self-inflating, have no a pop-off valve, and have an anatomically shaped, clear mask.

List signs of respiratory failure in children:

Increased respiratory effort with retractions, breathing less than 10 per minute, head bobbing, grunting, accessory muscle use, absent or shallow chest wall movement, limp muscle tone, altered mental status, slow or absent heart rate, poor skin perfusion, and altered mental status.

Signs of impending cardiac arrest in a pediatric patient are:

Altered mental status, bradycardia, and cyanosis.

For a heat exhaustion patient, when is it appropriate to give fluids orally?

Consious and not nauseated, and able to drink without assistance.

What position should a nauseated patient be transported in?

left lateral recumbent.

If your choking patient becomes unconsious, you should:

Begin CPR

Your pediatric patient choked on a small toy piece. He is conscious and crying, but has labored breathing and stridor. You should:

Monitor closely and transport in the position of comfort with blowby oxygen administration as tolerated.

For a patient who has ingested a poison, you should contact:

Medical Direction (Poison Control can not give treatment orders to EMS providers.)

Before an advanced airway is placed, during CPR the adult patient should be ventilated every ____-____ seconds to a rate of _____-_____ breaths per minute.

5-6 seconds (10-12 bpm)

After an advanced airway is placed, the adult patient should be ventilated every ____-____ seconds to a rate of _____ - _____ breaths per minute.

6-8 seconds (8-10 bpm)

During rescue breathing, each breath should be given over:

1 second.

The primary advantage of a nasopharyngeal airway is:

that it can be used in a patient who has an intact gag reflex.

BVM's must have a volume of at least _____mL for newborns and infants.

500 (Child BVM)

For infants and children, ventilations should be delivered every ____-____ seconds once an advanced airway is in place.

2-3 (20-30 breaths per minute)

When an advanced airway is in place you should not pause compressions for ventilations.

True or False

True

Which should occur first:

Turn on the AED or Attach the AED patches

Turn on the AED

For EMT's, a maximum of ___ defibrillations should occur before beginning transport.

3

You are at a local elementary school at an event, off duty, when a child collapses in sudden cardiac arrest. An AED is available, but it does not have pediatric patches, you should:

Ensure quality CPR and use the adult patches to assess for a shockable rhythm.

The time goal for recognition of stroke symptoms until time of arrival at a stroke center is ____ hours.

3.5

Skin exposed to chemicals should be flushed for at least ____ minutes.

20

Burn patients with burns less than _____ % can be treated with moistened dressings for comfort.

10% (NYS protocol)

An open fracture is

any open wound near a suspected bone injury.

When can a limb be manually realigned?

Severe long bone fracture with deformity. Dislocations should only be repositioned if distal cyanosis and loss of distal pulses occurs.

When is extremity traction contraindicated?

Injury close to the knee, hip, or pelvis, partial amputation or avulsion with bone separation, and injury to the lower leg or ankle.

Trauma Field Triage decisions are based 3 criteria. Those are:

Injuries found, vitals, mechanism of injury.

Adult trauma patients with a respiratory rates less than ____ or greater than ____ should be transported to the trauma center.

10 or 29

Chemical burns to the eyes must be irrigated for a minimum of _____ minutes.

20

For eyes injuries you should bandage

(the injured eye/both eyes)

Both eyes to reduce sympathetic eye movement.

Your patient is on a NRB at 12 lpm. The reservoir fully collapses with each breath the patient takes. You should:

Increase the flow to 15 lpm.

You can assume the patient is hypoperfusing with a BP less than 90mmHG if what clinical signs are present:

loss of peripheral pulses and altered mental status

Ventilations should be provided if an infants heart rate is less than ______bpm.

100

CPR should be started if an infants heart rate is less than _____bpm.

60

If a newborn infant's respiratory rate is depressed and central cyanosis is present you should:

Position and stimulate the baby, suction the mouth and nose as needed, and begin ventilations if there is no clinical improvement.

When is it appropriate to insert sterile gloved hand/fingers into the vagina during childbirth?

Breech birth that is not progressing and prolapsed umbilical cord.

Nebulized albuterol is administered with an O2 flow rate of:

4-6 LPM.

Your patient has a GCS of 14. He is refusing to go to the hospital despite being told that he may have serious internal injuries due to the mechanism of injury he sustained. You should:

Request police and contact medical direction. GCS must be 15 to be considered mentally competent to refuse care.

Your patient has hemophilia fell from a ladder. On your arrival his wife is preparing to administer an infusion of his prescribing clotting factor concentrate. You should:

Allow her to proceed, and contact medical control if transport may be delayed.

Hyperventilation causes a _____ in CO2 levels which in turn causes the blood vessels of the brain to _______________.

decrease, constrict

Excessive hyperventilation can lead to cerebral _________________.

Cerebral hypoxemia due to excessive cerebral vasoconstriction.

A single episode of ______________________ or ________________________ significantly increases moratility due to head trauma.

hypoxia, hypotension

Cushing's triad indicates

increased intracranial pressure

Cushing's triad consists of:

Increased systolic BP, decreased heart rate, and abnormal respirations.

Colormetric CO2 detectors turn ________ when CO2 is exhaled, confirming the ET tube is in the trachea.

Yellow

During CPR, your patinet has an ETCO2 of 8. You should:

Assure high quality CPR is being performed.

During CPR, your patient's ETCO2 rapidly changes from 12 to 20mmHg. You should:

Assess for return of spontaneous circulation. (ROSC)

Pediatric AED patches are designed for use on children ________ years of age.

1-8

For patient's with potential tuberculosis, the most appropriate BSI includes:

Gloves and a #M sub-micron molded surgical mask

Potential infectious disease exposures must be reported to you agencies:

Infection Control Officer.

According to NYS policy, who can consent to or refuse medical care for themself:

Any person who is 18 years of age, or is pregnant or the parent of a child, or who has married

What is the Abandoned Infant Protection Act

It grants immunity to anyone abandoning an infant (5 days old or less) at a safe place. This can be done anonymously, and requires that someone is immediately notified of where the baby was left.

How long does an EMS provider have to submit written documentation of suspected child abuse or neglect?

48 hours

(The verbal report to the NYS Child Abuse and Maltreatment Register should be made immediately after transferring care to the ED.)

Airborn disease protection requires the use of:

#M sub-micron molded surgical mask (Ex N95), and plaing a surgical mask on the patient unless the patient is on O2 via mask

Droplet protection requires:

disposable gown, gloves, googles and mask when within 6.5 feet of the patient.

Common droplet spead infections disease

Measles, mumps, chicken pox, meningitis, tuberculosis, pneumonia, common cold, influenza

The antidote for nerve agents is:

Atropine first, then prallidozime (2-PAM), this is the Mark I Kit

What PPE is required for nerve agents:

SCBA, goggles, gloves made of viton, nitrile, or neoprene, and protective coveralls or aprons.

What does SLUDGEM stand for

Salivation, lacrimation, urination, defecation, GI upset, emesis, miosis/muscle (twitching, spasm, "bag of worms")

If severe signs and symptoms of nerve agent exposure are presnt, how many Mark I Kits should be administered?

3 in rapid succession

As children grow older their heart rate becomes ___________ and there BP __________.

HR slower, BP increases

The blood pressure cuff should covered about ___________ of the patient's upper arm when properly sized.

two thirds (2/3rds)

When possible, suction should be limited to _________________ seconds.

10

The microscopic sacs in the lungs where gas exchanges with the cells are called:

Alveoli