EMT EXAM #1

When do you use an OPA (Oropharyngeal Airway), and when should it be removed?

An OPA is utilized on an unresponsive patient who does not possess a gag reflex, allowing for airway management without reflexive obstruction. It must be removed immediately if the patient exhibits any signs of gagging, swallowing, or regaining consciousness.

What causes a partial airway obstruction, and what do the different airway noises indicate?

Partial airway obstruction can be caused by the tongue, swelling, foreign objects, or fluids obstructing airflow. Different sounds indicate specific issues: Snoring signifies partial obstruction caused by the tongue; Stridor indicates swelling or a foreign object in the upper airway; Wheezing suggests constriction in the lower airway; and Gurgling points to fluid present in the airway.

How do you treat an abdominal evisceration?

In treating an abdominal evisceration, do not attempt to push the protruding organs back into the cavity. Instead, cover the exposed organs with a sterile dressing that is moistened with saline, and apply an occlusive dressing over it to preserve moisture and warmth.

What is the correct chest compression rate for CPR across all age groups?

The recommended chest compression rate for CPR is between 100 and 120 compressions per minute across all age groups.

What are you assessing for when ventilating a patient with a Bag-Valve Mask (BVM)?

When using a BVM, you should check for adequate chest rise and fall, monitor the compliance of the bag (indicating resistance), and observe for improvements in skin coloration and heart rate.

What are the early and late signs of shock?

Early (Compensated): Symptoms include restlessness, anxiety, pale/cool/clammy skin, and tachycardia (increased heart rate). Late (Decompensated): Indicators are hypotension (significantly low blood pressure), severely altered mental status, and weak or absent peripheral pulses.

What are the normal and abnormal respiratory rates for adults, children, and infants?

Normal respiratory rates: Adults (12–20 breaths/min), Children (15–30 breaths/min), Infants (25–50 breaths/min). Abnormal respiratory rates fall outside these ranges, or may involve shallow, irregular breathing, or the use of accessory muscles.

What are the bones of the foot, especially the major bone located on the bottom/heel?

The human foot consists of tarsals, metatarsals, and phalanges. The principal bone forming the heel at the bottom is known as the calcaneus.

What three characteristics are you feeling for when taking a patient's pulse?

When assessing a patient's pulse, you should evaluate the Rate (whether it is fast or slow), Rhythm (if it is regular or irregular), and Quality (whether it is strong and bounding versus weak and thready).

What is the functional difference between arteries and veins, and what is the pulmonary exception?

Arteries are responsible for transporting oxygenated blood away from the heart, while veins carry deoxygenated blood back to the heart. The exception to this rule is the Pulmonary Artery, which carries deoxygenated blood to the lungs, while the Pulmonary Veins carry oxygenated blood to the left atrium.

How do you properly splint a fracture?

To correctly splint a fracture, immobilize the joints above and below the fracture site. It is crucial to check Pulse, Motor, and Sensory (PMS) functions both before and after applying the splint.

What is the volume of air left in the lungs after you completely exhale called?

This volume of air is referred to as Residual Volume, which is vital for keeping the alveoli open to prevent lung collapse.

What structures make up the Central Nervous System (CNS)?

The Central Nervous System is comprised of the brain and the spinal cord, which coordinate the overall functioning of the body.

How do you treat a patient with suspected internal bleeding, and what should you NOT do?

You should administer high-flow oxygen, maintain body temperature to prevent shock, splint any fractures, and transport the patient rapidly. You should NOT administer anything by mouth (maintaining the patient NPO is critical).

What are the primary anatomical parts of the respiratory system?

The Upper Airway consists of the nose, mouth, pharynx, epiglottis, and larynx, while the Lower Airway includes the trachea, bronchi, bronchioles, and alveoli.

In human anatomy, what system are ligaments and tendons a part of?

Ligaments and tendons are integral components of the musculoskeletal system, contributing to the stability and mobility of the body.

What should you do for a responsive vs. an unresponsive choking patient?

For a responsive patient, perform abdominal thrusts (Heimlich maneuver for adults/children) or 5 back blows followed by 5 chest thrusts for infants. For an unresponsive patient, initiate CPR immediately; each time you open the airway to check for breaths, inspect the mouth and remove the visible obstruction if present—do not perform blind sweeps.

What is the correct hand or finger placement for CPR chest compressions?

For an adult or child, use two hands positioned on the lower half of the sternum. For infants, use two fingers centered on the chest just below the nipple line. In a two-rescuer scenario for infants, utilize two thumb-encircling hands.

What is the function of the Aorta, and what does it NOT do?

The Aorta functions to carry high-pressure, oxygen-rich blood from the left ventricle to supply the entire body. It does NOT transport deoxygenated blood and does NOT provide blood flow to the lungs.

What is the purpose of Critical Incident Stress Debriefing (CISD), and what does it NOT do?

CISD is designed to assist EMS personnel in processing psychological trauma encountered during difficult calls. It does NOT serve to assign blame or facilitate performance critiques.

Where does skin color primarily come from?

Skin color is mainly derived from the pigment melanin found in the epidermis, and it can be dynamically altered by blood perfusion (circulation) occurring in the dermis.

What are the different lung volumes?

Lung volumes include Tidal Volume (the volume of air inhaled or exhaled during a normal breath), Inspiratory Reserve Volume (the additional air that can be inhaled after a normal inhalation), Expiratory Reserve Volume (the additional air that can be exhaled after a normal exhalation), and Residual Volume (the air remaining in the lungs after a maximum exhalation).

Define the anatomical position terms: proximal, distal, and medial.

Proximal refers to being closer to the trunk of the body, Distal indicates being farther from the trunk, and Medial describes a position that is closer to the midline of the body.

What does the acronym SAMPLE stand for?

SAMPLE signifies Signs/Symptoms, Allergies, Medications, Past medical history, Last oral intake, and Events leading to the current situation.

When should you switch roles as the compressor during CPR?

Roles should be switched every 2 minutes or after every 5 cycles, typically coinciding with AED rhythm analysis, to prevent fatigue of the person performing chest compressions.

What protects you legally if you help someone in an emergency while you are off-duty and not on an ambulance?

The Good Samaritan Laws provide legal protection to individuals who offer assistance during emergencies, protecting them from liability.

How do you treat an unresponsive, non-breathing patient who has a pulse?

You must open the airway and deliver rescue breaths using a BVM (Bag-Valve Mask) with high-flow oxygen at a rate of 1 breath every 6 seconds for an adult.

How do you treat an open neck wound?

Immediately apply an occlusive dressing and tape it securely on all four sides to prevent air from entering the chest cavity (to avoid an air embolism), followed by applying direct pressure on the dressing.

What is the definition of an avulsion?

An avulsion refers to a type of soft tissue injury in which a piece of skin or tissue is torn loose completely or remains attached by a flap.

What anatomy is found in the epidermis vs. the dermis layers of the skin?

The epidermis consists of outer layers of dead cells and melanin (lacking blood vessels), while the dermis contains deeper structures, including hair follicles, sweat glands, nerves, and blood vessels.

How do you perform airway suctioning, and what are the maximum times?

Airway suctioning should be performed on the way out using a sweeping motion. Maximum suctioning times are 15 seconds for adults, 10 seconds for children, and 5 seconds for infants.

When should you NOT use an NPA (Nasopharyngeal Airway)?

An NPA should not be used in patients with severe facial trauma or suspected basilar skull fracture, as indicated by signs such as CSF drainage or raccoon eyes.

What functions does the skin perform, and what does it NOT do?

The skin acts as a protective barrier against pathogens, regulates body temperature, and retains fluids. However, it does NOT play a role in systemic gas exchange or nutrient digestion.

What is the pressure reading of a completely full medical oxygen tank?

A completely full medical oxygen tank typically reads between 2,000 and 2,200 psi.

What are the compression-to-ventilation ratios for CPR across all ages?

For CPR, the compression-to-ventilation ratios are: Adults (1 or 2 rescuers): 30:2; Children/Infants (1 rescuer): 30:2; Children/Infants (2 rescuers): 15:2.

How do you measure an OPA for proper sizing?

To size an OPA correctly, measure from the corner of the patient's mouth to the earlobe (or the angle of the jaw). Or measured from center of the mouth to the tip of the jaw.

What do the primary muscles of breathing do during inhalation?

During inhalation, the diaphragm contracts and moves downward, and the intercostal muscles contract to expand the rib cage upwards and outwards.

Give examples of distal/proximal and lateral/medial anatomical relationships.

Examples include that the wrist is distal to the elbow, while the shoulder is proximal to the elbow. Moreover, the nose is medial to the eyes, and the ears are lateral to the nose.

How are burns classified by depth?

Burns are categorized by depth as follows: Superficial (1st degree): Involves red, painful skin; Partial-thickness (2nd degree): Characterized by blisters and intense pain; Full-thickness (3rd degree): Results in charred, leathery, or white skin, often painless at the center.

What is the fraction of inspired oxygen (FiO2) of regular room air?

The fraction of inspired oxygen (FiO2) of standard room air is approximately 21%, equivalent to 0.21.

How do you treat a burn caused by dry chemicals?

For burns from dry chemicals, thoroughly brush off any remaining chemical particles before flushing the affected area with a large volume of water.

What do you need to insert an NPA?

To insert a Nasopharyngeal Airway (NPA), you require the correctly sized NPA tube (measured from the nose to the earlobe) and a water-soluble lubricant.

What components make up the Perfusion Triangle, and what is excluded?

The Perfusion Triangle consists of The Pump (heart), The Pipes (blood vessels), and The Fluid (blood). Components you would NOT include are respiratory structures or external oxygen supply.

What is the normal adult pulse range, and what terms describe a pulse that is too fast or too slow?

The normal pulse range for adults is 60–100 bpm. A pulse that is too fast is termed Tachycardia (greater than 100 bpm), while a pulse that is too slow is called Bradycardia (less than 60 bpm).

What does a snoring airway sound indicate, and what is wrong?

A snoring sound during respiration indicates a partial upper airway obstruction, typically due to the tongue falling back into the throat.

What does each chamber of the heart do?

• Right Atrium: Receives deoxygenated blood returning from the body.
• Right Ventricle: Pumps deoxygenated blood to the lungs for oxygenation.
• Left Atrium: Receives oxygenated blood from the lungs.
• Left Ventricle: Pumps oxygenated blood to the rest of the body.

What is the difference between hinge joints and ball-and-socket joints?

Hinge joints such as the elbow and knee allow movement in one plane (back-and-forth), while ball-and-socket joints such as the shoulder and hip permit multi-directional movement and rotational capability.

What are the components of blood called?

The components of blood include Red blood cells (erythrocytes), white blood cells (leukocytes), platelets (thrombocytes), and plasma, the liquid medium.

What is anatomically contained in the cardiovascular system based on the word root?

The cardiovascular system is anatomically comprised of the heart (cardio) and the network of blood vessels (vascular).

What is the name of the sac that surrounds and protects the heart?

The protective sac surrounding the heart is known as the pericardium, which provides cushioning and support.

What physically causes traumatic injuries to the human body?

Traumatic injuries result from the transmission of external kinetic or thermal energy that exceeds the structural tolerance of the body tissue.

What are the structural subdivisions of the nervous system?

The nervous system is divided into the Central Nervous System (CNS) comprising the brain and spinal cord, and the Peripheral Nervous System (PNS) which includes all the nerves outside the CNS. The PNS further divides into the Somatic (voluntary control) and Autonomic (involuntary control, which includes Sympathetic and Parasympathetic divisions).

How do you assess pupils, and what do their reactions mean?

Pupil assessment is conducted using the PEARRL acronym (Pupils Equal And Round, Reactive to Light). Constricted pupils may indicate narcotic use; dilated pupils could suggest shock or stimulant use; unequal pupils can signify head trauma or stroke.

What must you do to ensure high-quality, effective CPR chest compressions?

To perform effective CPR, compress the chest hard, with a depth of at least 2 inches, at a rate of 100–120 compressions per minute, while allowing for complete chest recoil to maximize blood circulation—minimize interruptions.

What is your highest absolute priority on any EMS call?

Your top priority during any EMS call is Scene Safety: first ensure your safety, then your partner's safety, and finally the patient's safety.

If a patient has no pulses in their arms and legs (peripheral), what does this mean?

Absence of pulses in the arms and legs indicates that the patient is likely in profound shock or cardiac arrest, as blood has been redirected to the body's core; a central carotid pulse check should confirm.

What is the correct mechanical technique for suctioning an airway?

To suction the airway properly, insert the suction catheter without activating suction, only as far as visible, and then apply suction compatibly—either continuously or intermittently—while withdrawing in a sweeping motion.

What oxygen percentages are delivered by a nasal cannula, NRB, BVM, and mouth-to-mask?

The oxygen delivered by different devices includes: Nasal Cannula: 24%–44%; Non-Rebreather Mask (NRB): 90%–95%+; Bag-Valve Mask (BVM) with reservoir: nearly 100%; Mouth-to-Mask (without O2): approximately 16%.

How do you treat an open, sucking chest wound?

For an open, sucking chest wound, apply an occlusive dressing that is taped on three sides, creating a one-way valve effect to allow air to escape while preventing additional air from entering.

What are the three classifications of burns?

Burn classifications include: Superficial (1st degree): Red, painful skin; Partial-Thickness (2nd degree): Involves blisters and intense pain; Full-Thickness (3rd degree): Results in charred, leathery, or white skin, often painless at the center.

What is the difference between a puncture wound and an impalement?

A puncture wound creates an empty tract in the skin; an impalement occurs when an object is lodged within the body. It is crucial to leave an impaled object in place unless it obstructs the airway or prevents CPR.

If a patient with an occlusive dressing develops severe difficulty breathing, what should you do?

In such a case, suspect a tension pneumothorax, and immediately 'burp' the occlusive dressing by lifting a corner to alleviate trapped air pressure.

What can you do for a severely deformed extremity fracture that has an absent distal pulse?

For such fractures, make one gentle attempt to realign the limb through manual traction along its length to restore circulation, prior to splinting; however, if resistance or severe pain occurs, splint the extremity in the position found.

How do you care for an avulsed tooth?

Handle an avulsed tooth only by the crown, rinse it gently with saline, and place it into a container of cold milk or sterile saline to preserve viability.

What is the Rule of Nines used for in burn assessments?

The Rule of Nines is a method employed to estimate the total body surface area (BSA) affected by burns, helping guide treatment decisions.

What is the medical term for a microorganism that causes disease?

A disease-causing microorganism is referred to as a pathogen.

What are the main components of blood?

The primary components of blood include Red blood cells (erythrocytes), white blood cells (leukocytes), platelets (thrombocytes), and the liquid component known as plasma.

How do you stop a severe internal abdominal bleed in the field?

It is not possible to stop severe internal bleeding pre-hospitally; instead, provide oxygen support, treat for shock by keeping the patient warm, and transport them rapidly to a medical facility.

What are the three different types of muscles in the body?

The three main muscle types are: Skeletal muscles (voluntary control, enabling movement), Smooth muscles (involuntary control found in organs), and Cardiac muscles (involuntary control specifically for the heart).

What are the bleeding characteristics of arteries, veins, and capillaries?

Arterial bleeding is bright red and spurting; venous bleeding is dark red and flows steadily; capillary bleeding is dark red and tends to ooze slowly.

How is CPR performed differently once an advanced airway is placed?

With an advanced airway in place, chest compressions continue without any pauses, while ventilations are delivered independently at a rate of 1 breath every 6 seconds.

What is the most effective way to prevent the spread of infectious disease?

The most effective method for preventing the spread of infectious diseases is thorough and consistent handwashing.

What is the descending order of the spine from top to bottom?

The spine's descending order is: Cervical (7 vertebrae), Thoracic (12 vertebrae), Lumbar (5 vertebrae), Sacral (5 fused vertebrae), and Coccygeal (4 fused vertebrae).

What components are required to prove legal negligence, and what is NOT needed?

To establish legal negligence, you must provide evidence of Duty to Act, Breach of Duty, Damages, and Causation. There is no requirement to demonstrate intent to cause harm.

How long do you check for a pulse in an unresponsive patient?

In an unresponsive patient, pulse checks should last for at least 5 seconds, but no longer than 10 seconds.

What do tendons and ligaments attach to?

Tendons connect muscles to bones, while ligaments attach bones to other bones to provide stability at joints.

What is the adult ventilation rate with an advanced airway per New York State protocol?

According to New York State protocol, the adult ventilation rate with an advanced airway is set at 1 breath every 6 seconds (which equals 10 breaths per minute), administered without pausing chest compressions.

How do you ensure you are connecting the correct regulator to an oxygen tank?

To ensure correct regulator connection, you should align the safety pins according to the Pin Index Safety System (PISS); for oxygen, the pins are at positions 2 and 5.

What are the percentage breakdowns for the adult Rule of Nines?

In the adult Rule of Nines, the percentage breakdown is as follows: Head: 9%; Each Arm: 9%; Chest/Abdomen: 18%; Back: 18%; Each Leg: 18%; Groin: 1%.

What should you do if your patient completely refuses a Non-Rebreather Mask (NRB)?

In case of a refusal of an NRB, ensure to explain the associated risks with refusal; if the patient continues to decline, offer a nasal cannula as a compromise while thoroughly documenting the refusal.

What do different skin conditions like pale, flushed, or jaundice indicate?

Pale skin typically indicates shock or poor perfusion; flushed skin might suggest heat exposure or carbon monoxide poisoning; jaundice indicates a problem with liver function.

What is your first priority when managing an electrocution patient?

Your foremost priority for an electrocution patient is to ensure the power source is off before approaching or providing care.

What is the proper medical term for the kneecap?

The medical designation for the kneecap is the patella.

What color does your skin turn if you severely lack oxygen?

In cases of severe oxygen deprivation, skin may appear cyanotic, manifesting as a blue or blue-gray coloration.

What is the primary clinical difference between early and late shock?

The primary clinical distinction between early and late shock lies in blood pressure; early shock may present with a normal blood pressure (compensated), while late shock is marked by a significant drop in blood pressure (decompensated).

What are common causes of stress for EMTs?

Common stressors for EMTs include prolonged shifts, lack of sleep, handling mass casualty situations, pediatric emergencies, and facing potential verbal or physical threats while on duty.

What is the anatomical term for the voice box?

The voice box is clinically referred to as the larynx.

How do you treat an amputated body part that has come off?

For a severed body part, it should be wrapped in a sterile dressing moistened with saline, placed in a sealed plastic bag, and that bag should then be placed inside a container of ice water; always avoid direct contact with ice.

Where do the systolic and diastolic blood pressure measurements come from?

The systolic pressure is measured during ventricular contraction, while the diastolic pressure is noted during the resting phase when the ventricles are relaxing and refilling with blood.

What layers of membrane cover the lungs and line the inside of the thoracic cavity?

The membranes covering the lungs and lining the thoracic cavity are known as the pleura; the visceral pleura covers the lungs themselves, while the parietal pleura lines the cavity.

Define a flail chest injury.

A flail chest injury is characterized by two or more adjacent ribs being fractured in multiple places, resulting in paradoxical movement of the chest wall during breathing.

Under HIPAA, who can you legally share a patient's private medical details with?

Under HIPAA, you may only share a patient's private medical information with hospital staff who are directly involved in their immediate medical care, or if required by legal mandate or subpoena.

What are the sequential steps to control severe external bleeding?

To control severe external bleeding, first apply firm direct pressure to the wound. If bleeding remains severe or uncontrolled, promptly apply a tourniquet at a high position and tighten it until the bleeding stops.

What is the definition of priapism, and what does it indicate in trauma?

Priapism refers to a persistent and painful erection; in the context of trauma, it typically indicates a serious spinal cord injury.

When does an EMT have a legal "duty to act"?

An EMT has a legal 'duty to act' when they are actively engaged in a scheduled shift for an EMS agency or when they choose to provide care during their off-duty time.

What is the difference between a medical sign and a symptom?

A sign is an observable or measurable finding, such as blood pressure or pulse rate, whereas a symptom is a subjective report from the patient, like pain or nausea.

What makes a patient's breathing clinically "good" (adequate) vs. "not good" (inadequate)?

Breathing is considered good when the rate is normal, breath sounds are clear, and there is good expansion of the chest. Not good breathing may be too fast or too slow, shallow, exhibit cyanotic skin, or utilize accessory muscles.

How do you manually open an airway in trauma vs. non-trauma patients?

For trauma patients, utilize the jaw-thrust maneuver to open the airway, while for non-trauma patients, employ the head-tilt/chin-lift method.

What is the difference between expressed and implied consent?

Expressed consent is given verbally or through a gesture by a competent adult, while implied consent is assumed for patients who are unconscious, altered, or minors experiencing a life-threatening situation.

What is the FiO2 of a patient on room air versus a patient receiving supplemental oxygen from a high-flow device?

The FiO2 level of a patient breathing room air is fixed at 21%, while patients utilizing high-flow oxygen devices, like a Non-Rebreather Mask (NRB) or BVM, can achieve FiO2 levels approaching 90% to 100%.