Comprehensive Emergency Medicine and Trauma Management Review

What is a complication of forceful bag-mask ventilation?

Aspiration due to air entering the stomach

Why can airway management be challenging in patients with Down syndrome?

Misaligned teeth and a larger tongue

In what area of the lungs does respiration occur?

Alveoli

What is the initial intervention for a 75-year-old male with severe respiratory distress and SpO2 87%?

Administer oxygen via nonrebreather mask at 10-15 L/min

What should you do for a conscious adult with severe airway obstruction who cannot speak?

Perform abdominal thrusts immediately

What is spina bifida?

A developmental defect in which the spine and spinal cord do not form properly

When should APGAR scores be calculated?

At 1 minute and 5 minutes after birth

What findings best describe septic shock?

Hypotension, infection, and fever

What are the three components of the Pediatric Assessment Triangle (PAT)?

Appearance, Work of Breathing, and Circulation to Skin

What should you do if a patient becomes pulseless and apneic during transport?

Stop the ambulance, begin CPR, attach the AED, and request ALS

What commonly causes chronic renal failure?

Hypertension and diabetes

Which abdominal organ is most likely to bleed profusely if injured?

Liver

What type of fracture is associated with osteoporosis or cancer and occurs with minimal force?

Pathologic fracture

What is the correct treatment for a 2-year-old child with a high fever?

Provide oxygen, expose the patient appropriately, and transport

If a baby's head is delivered face down during childbirth, what is this presentation called?

Cephalic presentation

What should the EMT consider when assessing a patient with bizarre behavior?

An acute mental illness may be causing the behavior

Who is primarily responsible for decisions regarding patient care at an MCI scene?

The Incident Commander or Medical Branch Director

Who is in charge when you arrive at an MCI before fire or law enforcement?

The most senior EMS provider on scene

Which patient may legally refuse care?

An alert and oriented patient who understands the risks and benefits of refusal

What is the most important information to provide during a hospital report?

Chief complaint, vital signs, medications, allergies, medical history, and treatments provided

Which patient does NOT justify Code 3 driving?

A patient without a life-threatening condition

When responding to a chlorine spill, where should you park the ambulance?

At least 300 feet upwind

How should you approach a medical helicopter?

Approach from the front only after receiving approval from the pilot and watch for hazards

What is the first rule of safe lifting?

Keep your back straight and lift with your legs

When is rapid extrication indicated?

When the scene is unsafe or immediate transport is required and the patient is not trapped

What should you do upon arriving at a multiple-patient incident after ensuring scene safety?

Begin triage and request additional resources if needed

What color indicates severe risk of terrorist attack in the Homeland Security Advisory System?

Red

What should you do if a patient with chest pain refuses treatment?

Ensure the patient is alert, oriented, and understands the risks of refusal

What is most important during transport?

Continue patient assessment, communication, and reassurance

For which situations are EMS personnel mandated reporters?

Child abuse, elder abuse, and sexual assault

How should you care for a terminally ill patient with a valid DNR?

Provide comfort care and emotional support

What is correct about sickle cell disease?

The red blood cells are abnormally shaped and carry oxygen less effectively

What finding is common after a generalized seizure?

Incontinence

What option should be offered to a sexual assault victim whenever possible?

The option of being treated by a provider of the same gender

What should you suspect in a child presenting with fever, headache, photophobia, altered mental status, and a rash?

Meningitis

What is the function of the coronary arteries?

To supply oxygenated blood to the myocardium

What are universal precautions?

Safety practices used to prevent contact with blood and body fluids

Which of the following is NOT part of the initial assessment?

Obtaining a blood pressure

What movement occurs when the head bends downward toward the chest?

Flexion

How is Hepatitis A most commonly transmitted?

Fecal-oral route through contaminated food or water

What is the most common cause of death in children outside the newborn period?

Respiratory failure

What is the likely condition for a construction worker in a hot environment with pale, moist skin, dizziness, nausea, and weakness?

Heat exhaustion

What beneficial effects does epinephrine have during anaphylaxis?

Bronchodilation and vasoconstriction

What signs are commonly associated with a stroke?

Facial droop, weakness, paralysis, vision changes, and speech deficits

What is hypoglycemia?

Low blood glucose level

What additional information should be obtained during a gynecologic emergency?

Menstrual history, pregnancy status, and related gynecologic information

How should circulation be assessed in a conscious patient?

Check radial pulse and assess skin color, temperature, and moisture

When are TB patients most contagious?

When they are coughing

Which diabetic patient should receive oral glucose?

A conscious patient with suspected hypoglycemia who can swallow

How do the kidneys help regulate blood pressure?

By regulating sodium and water balance

What is the normal blood glucose range?

Approximately 70-120 mg/dL

What are the signs and symptoms of hypoglycemia?

Altered mental status, cool clammy skin, weakness, dizziness, hunger, seizures

What are common signs and symptoms of hyperglycemia?

Warm dry skin, excessive thirst, frequent urination, fruity breath, altered mental status

What are Kussmaul respirations associated with?

Diabetic ketoacidosis (DKA)

Which patient should NOT receive oral glucose?

A patient who cannot swallow or has a decreased level of consciousness

What is the leading cause of shock in trauma patients?

Hemorrhage

What are the three stages of shock?

Compensated, decompensated, irreversible

What is cardiogenic shock?

Shock caused by failure of the heart to pump effectively

What is neurogenic shock?

Shock caused by loss of sympathetic nervous system control

What type of shock is commonly associated with severe allergic reactions?

Anaphylactic shock

What is septic shock?

A distributive shock caused by severe infection

What is obstructive shock?

Shock caused by a physical obstruction to circulation

What are the classic signs of compensated shock?

Tachycardia, cool clammy skin, anxiety, delayed capillary refill

What is often a late sign of shock?

Hypotension

What does START stand for?

Simple Triage and Rapid Treatment

What triage category is assigned to walking wounded patients?

Green (Minor)

A patient breathing more than 30 times per minute is assigned which START category?

Red (Immediate)

A patient who is not breathing begins breathing after airway repositioning. What category?

Red (Immediate)

A patient who remains apneic after airway repositioning is assigned which category?

Black (Deceased/Expectant)

What triage category is assigned to a patient who cannot follow simple commands?

Red (Immediate)

What color tag is used for delayed treatment patients?

Yellow

What color tag is used for immediate treatment patients?

Red

What color tag is used for minor injuries?

Green

What color tag is used for deceased or expectant patients?

Black

What does a DNR order instruct EMS providers?

Not to initiate CPR or advanced resuscitation efforts

What should an EMT do if there is doubt about the validity of a DNR?

Begin resuscitation and contact medical control

What is implied consent?

Consent assumed for an unconscious or incapacitated patient needing emergency care

What are the requirements for a valid refusal of care?

Patient must be alert, competent, informed, and understand risks

What is the best legal protection for an EMT?

A complete and accurate patient care report (PCR)

Why is documentation important?

It provides a legal record of patient care and continuity of care

What should be included in every PCR?

Assessment findings, treatments, times, patient response, and disposition

What is abandonment?

Termination of care without equal or higher medical authority assuming responsibility

What is negligence?

Failure to provide the standard of care resulting in harm

What is battery in EMS?

Treating a competent patient without consent

What is assault in EMS?

Creating fear of unwanted physical contact or treatment

Who can terminate the EMT-patient relationship?

Equal or higher medical authority or patient refusal when appropriate

What should be done first when arriving on scene?

Scene size-up and ensure scene safety

What are standard precautions used for?

Preventing exposure to bloodborne pathogens

What agency regulates workplace safety?

OSHA

What is the purpose of an incident command system (ICS)?

To organize resources and personnel during incidents

What does PPE stand for?

Personal Protective Equipment

What is the first priority at a hazardous materials incident?

Scene safety and personal safety

What position should an unconscious breathing patient generally be placed in?

Recovery position

What is the primary purpose of oxygen therapy?

To improve oxygen delivery to tissues

What is cyanosis?

Bluish discoloration caused by inadequate oxygenation

What is the most reliable indicator of adequate breathing?

Adequate chest rise and fall with normal mental status

What is the normal oxygen saturation range for most healthy adults?

95-100%

What is the purpose of a nonrebreather mask?

To deliver high-concentration oxygen

What is the purpose of a bag-valve mask (BVM)?

To provide positive-pressure ventilation to patients who are not breathing adequately

What is the maximum suction time for an adult?

15 seconds