Under Fire
During a Rescue Task Force deployment, EMTs should only enter the warm zone after receiving this authorization.
What is approval from Incident Command after law enforcement has established security?
At a multiple-casualty incident, the first arriving EMS unit should perform this action before beginning patient care.
What is establish command and perform a scene size-up?
An unresponsive diabetic patient has snoring respirations, equal chest rise, and a carotid pulse of 90/min. This assessment finding requires immediate intervention before obtaining a blood glucose level.
What is an airway obstruction requiring airway management?
A febrile 3-year-old suddenly has a generalized tonic-clonic seizure lasting two minutes and begins crying afterward. The highest priority after the seizure stops is this.
What is maintaining the airway and assessing breathing?
A patient with chest pain has a heart rate of 42/min, blood pressure of 74/48 mmHg, cool clammy skin, and altered mental status. These findings indicate this type of shock.
What is cardiogenic shock?
A patient in the warm zone has severe extremity bleeding, an open femur fracture, and a suspected spinal injury. Because of the tactical environment, your immediate treatment priority is this.
What is controlling the life-threatening hemorrhage before addressing other injuries?
While responding emergently with lights and sirens, another driver fails to yield at an intersection. According to safe ambulance operations, your next action is this.
What is come to a complete stop (or nearly stop) until the intersection is confirmed clear?
During the primary assessment, you discover a patient with shallow respirations at 8 breaths per minute, weak radial pulses, and cool, clammy skin. This finding should take priority over obtaining a SAMPLE history.
What is identifying and managing inadequate breathing?
A 6-year-old who fell from a second-story window is alert but repeatedly becomes sleepy and vomits twice during transport. These assessment findings suggest this injury.
What is increasing intracranial pressure from a traumatic brain injury?
A patient with severe chest pain has equal breath sounds, trachea is midline, and blood pressure differs by more than 20 mmHg between the arms. These findings should make you suspect this life-threatening condition
What is an aortic dissection?
A Tactical EMS team enters the warm zone without eye protection or body armor required by agency policy because "it's probably safe now." This violates this core operational principle.
What is using appropriate personal protective equipment and maintaining responder safety?
During a radio report, the EMT states, "The patient has chest pain, BP 82/50, pale and diaphoretic, requesting ALS intercept." This portion of the report communicates this information.
What is the patient's priority condition and resource request?
A patient with chest pain has a blood pressure of 84/50 mmHg, clear lung sounds, and jugular venous distention after a motor vehicle collision.
What is obstructive shock, possibly from cardiac tamponade?
A 6-month-old infant is pale, has weak peripheral pulses, delayed capillary refill, and a heart rate of 70/min after a prolonged illness. The bradycardia is most likely caused by this underlying problem.
What is hypoxia?
During your assessment of a patient with chest pain, you discover they took sildenafil three hours ago. This medication is contraindicated because of the risk of this complication.
What is profound hypotension from nitroglycerin administration?
During a Rescue Task Force deployment, you complete life-threatening hemorrhage control on a patient when law enforcement suddenly orders an immediate evacuation because the threat environment has changed. Your next action is this.
What is immediately evacuate with law enforcement, even if treatment is incomplete?
During a hazardous materials incident, EMS personnel begin entering the warm zone without assignment from Incident Command. This violates this ICS principle.
What is maintaining scene accountability through the chain of command (unity of command)?
A patient involved in a high-speed motorcycle crash is alert, oriented, and insists they are "fine." Your assessment reveals tachycardia, mild tachypnea, abdominal tenderness, and increasing restlessness. Despite the patient's mental status, these findings most strongly suggest this.
What is compensated hemorrhagic shock from internal bleeding?
A 2-year-old who was found submerged in a backyard pool is breathing spontaneously after rescue but remains unresponsive. Lung sounds are clear and oxygen saturation is 99%. Despite these findings, your assessment should continue to focus on this life-threatening complication.
What is hypoxic brain injury with the potential for recurrent respiratory compromise?
A patient with crushing substernal chest pain has cool clammy skin, jugular venous distention, and clear lung sounds. These assessment findings are most consistent with this type of myocardial infarction.
What is a right ventricular myocardial infarction?
During a tactical incident, you encounter one patient with a severe arterial bleed and another who is unconscious, apneic, and pulseless. Given limited resources and an ongoing threat, your first lifesaving intervention should be directed toward this patient.
Who is the patient with the severe arterial hemorrhage?
During a STEMI alert, an EMT tells the receiving hospital, "This guy is definitely having a massive heart attack." This statement violates this communication principle
What is reporting objective assessment findings instead of making definitive diagnoses?
During your assessment of a trauma patient, you find absent radial pulses but strong carotid pulses. Without using a blood pressure cuff, this finding suggests the systolic blood pressure is likely below this value.
What is 80 mmHg?
A 3-year-old with a severe head injury opens their eyes to pain, withdraws from painful stimuli, and cries incomprehensibly. Based on your assessment, this is the child's Glasgow Coma Scale score.
What is a GCS of 8?
An elderly patient complains only of fatigue, dizziness, and weakness after mowing the lawn. During your assessment, you note diaphoresis and hypotension but no chest pain. This diagnosis should remain high on your differential.
What is acute coronary syndrome with an atypical presentation?