Airway
Small air sacs at the end of the airway that are responsible for gas exchange
What are alveoli?
A 20 yr old male was the unrestrained driver in a car crash. He is anxious, pale and has absent lung sounds on the left side. Vital signs are BP 80/48, P 132, R 312 and shallow. What should you suspect?
Tension Pneumothorax
Receives oxygenated blood from the lungs
What is the R atrium?
Painless, bright red vaginal bleeding in a third trimester pregnant pt is likely caused by
Placenta Previa
A 62 yr old male tells you he has been experiencing headaches when he wakes up in the morning. He called you because he woke up today with left arm weakness. He says he bit his tongue while sleeping. You suspect a:
A) stroke due to an intracerebral bleed
B) seizure due to a brain tumor
C) seizure due to a stroke
D) stroke due to ischemia
Seizure due to a brain tumor
(Look at this question as sudden vs gradual onset)
Describe the Pathophysiology of COPD. What treatment would be a no-go out in the field for these patients?
Normal respiratory drive initiates ventilation due to high amounts of CO2. Someone who has COPD has maintained high levels of CO2 for a long time (chronic), therefore their bodies have had to adjust and instead now ventilation is initiated due to low levels of O2. In the field, high flow oxygen should not be given to pts with COPD. Their bodies will see the high amount of O2 coming in and think that it does not need to ventilate while the high amount of O2 is present.
You respond to a residence for a 40-year-old male who was assaulted by his wife; the scene is secure. The patient is lying supine on the kitchen floor. He is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular vein distention, and unilaterally absent breath sounds. As your partner is supporting his ventilations, you should:
A) insert an OPA
B) obtain a set of vitals
C) perform a detailed physical exam
D) immediately request ALS support
Immediately request ALS support
How does Angina Pectoris differ from an Acute Myocardial Infarction (AMI)?
A) angina pectoris will only present with chest pain
B) nitroglycerin is not indicated by angina pectoris pain
C) angina pectoris pain typically lasts longer than AMI pain
D) heart muscle can be permanently damaged by an AMI
Heart muscle can be permanently damaged by an AMI
You are dispatched to a residence for a 4 yr old girl who is sick. Your assessment reveals that she has increased work of breathing and is making a high-pitched sound during inhalation. Her mother tells you that she has been running a high fever for the past 24 hours. Your MOST immediate concern should be:
A) preparing to treat her for a febrile seizure
B) taking her temp to see how high it is
C) assessing the need for ventilation assistance
D) determining if the child has a history of croup
Assessing the need for ventilation assistance
You are treating a patient who complains of respiratory distress. He is breathing rapidly but shallowly and can speak only one-to-two word sentences. His skin color is poor and he appears tired. His family states that he has "bad" chronic bronchitis and congestive heart failure. You should:
A) administer oxygen via nasal cannula
B) administer oxygen via venturi mask
C) administer oxygen via non-rebreather mask
D) administer ventilations via BVM
Administer ventilations via BVM
(Pt is already in poor respiratory condition and not getting adequate tidal volume AKA shallow breathing)
A 75 yr old female pt complains of right sided chest pain and dyspnea. She has been recovering from recent hip surgery. What do you suspect?
What is Pulmonary Embolism?
Cardiac Tamponade, Sepsis, Vomiting/Diarrhea, AMI
What are the 4 types of shock?
Obstructive, Distributive, Hypovolemic, Cardiogenic
The six links of the out of hospital chain of survival
What are activation of emergency response - high quality CPR - defibrillation - advanced resuscitation - post cardiac arrest care - recovery?
A newborn is apneic immediately after delivery. How should you deliver ventilations?
A) mouth to mask device with small puffs at a rate of 60-100/min
B) neonatal bvm with small puffs at a rate of 40-60/min
C) mouth to mask device with small puffs at a rate of 40-60/min
D) neonatal bvm with small puffs at a rate of 60-100/min
Neonatal BVM with small puffs at a rate of 40-60/min
A drowsy 19 yr old male was stabbed with a knife over the left side of his anterior chest. His skin is cool and clammy and his vitals are B/P 104/82, P 118, R 22 and SpO2 is 94% on room air. What type of shock is he suffering?
A) Metabolic
B) Cardiogenic
C) Hypovolemic
D) Distributive
Cardiogenic
(What's causing the issue?)
During the initial assessment of a semiconscious patient’s airway, snoring respiration’s are heard. What do these indicate?
A) mucus or secretions in the larger airway
B) fluid in the upper airway
C) constricted bronchi
D) a partially obstructed airway
A partially obstructed airway
a 56 yr old diabetic man is found unresponsive by his wife. She tells you that he ate breakfast this morning, but is unsure if he took his insulin. His respirations are rapid and shallow, his skin is cool and profusely diaphoretic, and his pulse is rapid and weak. Which of the following statements regarding this patient is correct?
A) The fact that he ate breakfast makes hypoglycemia highly unlikely
B) He probably did not take his insulin and has a high blood glucose level
C) You should request an ALS unit so they can give the patient his insulin
D) He needs glucose as soon as possible because he is likely hypoglycemic
He needs glucose as soon as possible because he is likely hypoglycemic
(rapid/shallow=hypoglycemia, rapid/deep=hyperglycemia)
How can Angina Pectoris be distinguished from an AMI in a prehospital setting?
A) angina will not reveal changes on an electrocardiogram
B) angina and AMI are indistinguishable in a prehospital setting
C) a patient with an AMI will have more pain
D) chest pain from angina will respond to nitro, while chest pain from an AMI will not
Angina and AMI are indistinguishable in a prehospital setting
A 30 yr old female has nausea, vomiting, and lower, left-sided abdominal cramping. She tells you that she has been dizzy and light-headed. What should you suspect?
A) ectopic pregnancy
B) gastroenteritis
C) appendicitis
D) urinary tract infection
Ectopic Pregnancy
A violent 81 yr old man with a history of Alzheimer's needs to be transported because he is SOB and has an SpO2 of 85% on room air. You should:
A) approach him from two sides to restrain him
B) move him to the ground to control him
C) apply oxygen to improve his hypoxia
D) have three partners to restrain him
(O2 is the goal, but you need to restrain him first. Need one person per extremity)
Which of the following happens during the inhalation phase of ventilation?
A) the diaphragm contracts, moving upward, forcing the lungs to expand
B) the diaphragm relaxes, decreasing the space in the chest cavity
C) the diaphragm and intercostal muscles contract, enlarging the chest cavity
D) the diaphragm contracts and the intercostal muscles relax, enlarging the chest cavity
The diaphragm and intercostal muscles contract, enlarging the chest cavity
You are dispatched to a residence for a young female who is "sick." The pt complains of a rash to their lower extremities and truncal area. Your assessment reveals a small, painful blister on her inner thigh. As your partner is taking the patient's vital signs, she states that she and her family returned from a camping trip 2 days ago. Based off of her presentation, what do you suspect:
A) Lyme Disease
B) Allergic Reaction
C) Exposure to poison ivy
D) Rocky mountain spotted fever
Rocky Mountain Spotted Fever
How does right-sided heart failure form as a result of left-sided heart failure?
Left-sided heart failure occurs when the left ventricle is unable to pump properly. Blood starts to backup and work it’s way all the way back to the right ventricle, which then fails to pump adequately as well. This causes blood to backup into the extremities, which is a marquee sign of right-sided heart failure.
What is the greatest risk of fetal death?
Trauma and distress of the mother
An 89 yr old diabetic woman is unable to smile and has right arm drift. Her vital signs are BP 138/86, P 88, R 16 and her SpO1 is 95% on room air. You should first:
A) administer oral glucose
B) prepare for rapid transport
C) administer oxygen by non-rebreather mask
D) assess her mental status
Administer oral glucose