Potpourri
An EMT is preparing to administer a medication but notices the label concentration does not match the concentration specified in the protocol. Before proceeding, the EMT should do this
What is stop, verify the medication and concentration, and resolve the discrepancy before administration?
A 72-year-old suddenly develops right-sided weakness, slurred speech, and facial droop while eating breakfast. Before activating a stroke alert, this assessment should be performed because it may identify a completely reversible cause.
What is obtaining a blood glucose level?
A COPD patient initially has a respiratory rate of 34/min with accessory muscle use. Ten minutes later, the respiratory rate falls to 12/min, accessory muscle use disappears, and the patient becomes increasingly lethargic. Rather than improvement, these findings indicate this.
What is respiratory muscle fatigue leading to respiratory failure?
A trauma patient's vital signs change from 132/78 mmHg to 112/92 mmHg over 10 minutes. Although the systolic pressure has fallen only modestly, the narrowing pulse pressure should make you suspect this.
What is worsening shock with decreasing cardiac output?
A patient with an inferior myocardial infarction is hypotensive with clear lung sounds and jugular venous distention. These findings suggest dysfunction of this heart chamber.
What is the right ventricle?
A 2-year-old with bronchiolitis initially has severe retractions and a respiratory rate of 58/min. Ten minutes later the respiratory rate is 24/min, retractions have disappeared, and the child is limp with poor muscle tone. This change indicates this.
What is respiratory failure from exhaustion, not clinical improvement?
A confused diabetic has a blood glucose level of 118 mg/dL, but remains pale, diaphoretic, tachycardic, and hypotensive after treatment for hypoglycemia. These assessment findings suggest this.
What is another underlying cause of altered mental status, such as shock or sepsis, rather than persistent hypoglycemia?
A 56-year-old patient with severe shortness of breath has inspiratory stridor, is drooling, speaking only one-word answers, and is sitting in the tripod position. Despite an SpO₂ of 96%, the assessment finding that most strongly predicts impending airway failure is this.
What is inspiratory stridor with inability to manage secretions (drooling)?
An unresponsive patient opens their eyes only to pain, uses inappropriate words, and withdraws from painful stimuli. Calculate this GCS score.
What is a GCS of 10?
A patient has a heart rate of 180/min. Although the rate is very fast, blood pressure falls because this phase of the cardiac cycle becomes too short.
What is ventricular diastolic filling?
A 16-year-old with a history of severe asthma is sitting upright, speaking one-word sentences, and suddenly develops markedly diminished wheezing despite worsening respiratory distress. This assessment finding should alarm you because it indicates this.
What is a "silent chest" indicating impending respiratory arrest?
A 58-year-old diabetic complains only of weakness and nausea. Assessment reveals:
Although the blood glucose is markedly elevated, the assessment finding that most strongly indicates the patient is critically ill is this.
What are the deep, rapid (Kussmaul) respirations indicating severe metabolic acidosis?
A 3-year-old with severe croup is initially crying loudly with marked stridor and retractions. During transport, the child becomes quiet, stops crying, develops decreased stridor, and becomes lethargic. This change most likely indicates this.
What is impending complete airway obstruction from respiratory fatigue?
During a painful stimulus, a patient pulls their arm away from you but does not attempt to reach toward or remove your hand. Many students incorrectly score this as "localizes pain." The correct motor score is this.
What is Motor = 4 (withdraws from pain)?
During suctioning, an EMT inserts the catheter too deeply and repeatedly stimulates this highly sensitive airway structure, causing the patient to cough violently.
What is the carina?
A 74-year-old patient is found sitting in a chair complaining only of weakness. Assessment reveals:
The patient's blood pressure appears adequate, but the finding that should most concern the EMT is this.
What is worsening mental status from inadequate cerebral perfusion?
A diabetic patient is found unconscious after exercising. Assessment reveals:
During transport, the patient develops unilateral weakness despite improving blood glucose after treatment. This condition should now become a high priority on your differential diagnosis.
What is an acute stroke?
A patient with severe respiratory distress insists, "I'm starting to feel better." At the same time, you observe that wheezing has nearly disappeared, the patient becomes drowsy, and air movement is minimal. Rather than improvement, this combination of findings indicates this.
What is impending respiratory failure with a silent chest?
A patient with a traumatic brain injury receives sedating medication from ALS. Fifteen minutes later, the patient's GCS decreases from 14 to 10. Before concluding the brain injury has worsened, the EMT should consider this factor.
What is the effect of the sedating medication on the neurologic examination?
A patient has:
The fluid filling the alveoli originated because pressure increased behind this heart chamber.
What is the left ventricle?
An unconscious patient has:
A new EMT prepares to obtain a blood pressure and SAMPLE history. According to the NREMT assessment sequence, the next priority is this.
What is assisting ventilations with a bag-valve mask?
A diabetic dialysis patient is found confused with a blood glucose of 52 mg/dL. Despite treatment with oral glucose, the patient becomes increasingly lethargic and develops peaked T waves on the cardiac monitor. These findings suggest this additional life-threatening condition.
What is hyperkalemia?
A patient with severe respiratory distress has:
Which assessment finding should most influence your treatment?
hat is the patient's increased work of breathing and inability to speak in full sentences, indicating impending respiratory failure?
A patient has:
This GCS score should make you highly concerned about the patient's ability to protect their airway.
What is a GCS of 9?
A patient with severe emphysema has destruction of the alveolar walls. Although ventilation may still occur, gas exchange is significantly impaired because this anatomical feature has been lost.
What is alveolar surface area available for diffusion?