What should ya do
our patient is a 17 year old male found face down in a swimming pool. He is currently being held face up at the surface of the water. He is unconscious but breathing and has a pulse. What is the best course of action for this patient?
1. Jump into the pool and begin CPR
2. Remove the patient from the pool, immobilize, and transport.
3. Apply cervical and spinal immobilization while the patient is still in the pool
4. Wait for a trained water rescue team
3. Apply cervical and spinal immobilization while the patient is still in the pool
Your neuro assessment of an unresponsive patient reveals pinpoint pupils. What is your primary field diagnosis?
1. Beta blocker overdose
2. Insulin overdose
3. Aspirin
4. Narcotic
Narcotic
If a patient refuses treatment and an EMT treats the patient anyway, what crime can the EMT be charged with?
1. Medical Malpractice
2. Battery
3. Slander
4. Kidnapping
2
The kidneys help to regulate blood pressure by:
A. Eliminating toxic waste products from the body.
B. Retaining key electrolytes, such as potassium.
C. Accommodating a large amount of blood volume.
D. Removing sodium and water from the body.
D
Pt is a 27 yo female. She presents to the ED with:
-Extreme fever - 111 F
-agitation, sweating, tachycardia, tachypnea, and hypertension.
- dilated pupils
She also describes a bad pain in the center of her chest - she's panicking, claiming it's a heart attack.
- You administer Lorazepam for the agitation, hypertension, and tachycardia
- You get her in an ice water bath to cool her down ASAP
- Otherwise, all you can do is observe and support
What did this woman have?
Cocaine
You have just arrived on scene of a single vehicle accident involving a truck that has slid off the road and rolled. Your patient was driving about 40 MPH when he hit an icy spot and went off the road rolling the vehicle one time. After completing your scene size up, which of the following treatment choices would be the most appropriate?
1. Perform a rapid trauma assessment
2. Check baseline vitals, do a focused exam on the patient's chief complaint
3. Perform a detailed physical examination to uncover any life threatening injuries
4. Get a SAMPLE history and do a focused physical examination
1
You are called to a home where a 91 year old man has had a syncopal episode and is vomiting. The caregiver who called 911 stated that the patient's bowel movements have been bright red since yesterday. The patient has not complained of any pain, but is nauseated. What is most likely wrong with this man and which choice includes appropriate treatment steps?
1. He has an upper GI bleed and should be transported sitting up with high flow O2 administered via a non rebreather mask at 15 LPM.
2. He has pancreatitis and should be given high flow O2 via NRB at 15 LPM. Rapid transport in a left lateral recumbent position while keeping him warm will help avoid shock.
3. He has had a TIA and should be given high flow oxygen via NRB and transported on his affected side to the nearest hospital.
4. He has a lower GI bleed and should be given O2 via nasal cannula at 4LPM and transported in a position of comfort while treating for shock
4
While responding to a Hazardous Materials incident, the EMT should approach the scene from _________?
1. Up wind, Uphill, Up river
2. Up wind, Uphill, down river
3. Down wind, Down hill, Down river
4. Down wind, Over a hill, Down river
1
Which of the following organs assist in the filtration of blood, serves as a blood Reservoir, and produces antibodies?
A. Kidneys.
B. Liver.
C. Pancreas.
D. Spleen.
Spleen
A 15 yo male presents to your ED with his mom.
He has suffered vision changes, and his heart is racing. He also feels really warm.
PE:
Face and skin are flushed and red
Skin is very dry
Bowel sounds: absent
Tachypnea & tachycardia
Hx
He hasn't been able to pee for hours now
he has bad allergies. He took several _____ earlier for them
You treat him with Physostigmine
What's going on with this kid?
Anticholinergic Overdose/Toxicity
Benadryl
A 73 year old female was in her backyard gardening when she collapsed to the ground. Her husband told 911 that "she is breathing very fast and will not talk to me." You arrive to find the woman lying on her side in the grass. She is breathing at 7 breaths per minute and her pulse is irregular and very thready. Her lungs also present with crackles upon auscultation As you are taking a blood pressure (88/66) the husband tells you that the woman has been having jaw pain and some weakness for approximately 3 days. What is the most likely cause of this woman's condition and how would you treat her?
1. Hypoperfusion, High flow O2, and transport in Fowler's position
2. Cardiac arrest, Treat for shock, and rapid transport
3. Cardiogenic shock, Assist ventilations, and transport
4. Septic shock, Transport in a position of comfort with high flow O2 via NRB
3. Cardiogenic shock, assist ventilations and transport
You arrive on scene with your partner Levi to transport a patient that has been throwing up blood that looked like coffee grounds. This sign would lead you to believe that this patient has?
1. Esophageal Varices
2. GI bleed
3. Pancytopenia
4. Hemophagocytic syndrome
2
Pt is an 84 yo female. She's been brought in by her daughter. The pt lives alone in an older home without central air
A few days ago, the daughter noted that "mom's face looked red, and she had complained of nausea and a headache"
Today, the pt was confused, agitated, and ataxic. She did not seem to be sweating at all
PE:
pt is hyperventilating
Core temp is 40 C (104F)
Heat Stroke
Which of the following organs lies in the retroperitoneal space?
A. Gallbladder.
B. Spleen.
C. Liver.
D. Pancreas
Pancreas
Pt is a 36 yo migrant farm worker. He comes in with the following Sx:
-Weak, heart racing
-can't stop going to the bathroom, drooling, tearing up for no reason
PE: HTN, tachycardia, miosis present
Cholinergic Toxicity
A 60 year old female presents with a tearing sensation in her lower back. Her skin is sweaty, and she is tachycardic. The EMT should suspect:
A. Acute pancreatitis.
B. Aortic aneurysm.
C. Strangulated hernia.
D. Kidney stones.
Aortic aneurysm
Pain that radiates to the right lower quadrant of the umbilical area, nausea and vomiting, and lack of appetite are most indicative of:
A. Gastroenteritis
B. Pancreatitis.
C. Cholecystitis
D. Appendicitis
D
Pt is a 34 yo female. She was hiking Mt.Hood, when she began to feel very ill.
She has a dry cough, and impaired exercise capacity. Even at rest, she had dyspnea, and severe weakness. She was becoming cyanotic by the time her friends had taken her back down.
PE:
Rales present bilaterally
Tachypnea, tachycardia
O2 sat is 89% RA
EKG shows Right axis deviation
What did this woman have going on?
High Altitude Pulmonary Edema (HAPE)
Which of the following organs would most likely bleed profusely if injured?
A. Liver.
B. Stomach.
C. Gallbladder.
D. Appendix
Liver
Pt is a 32 yo male, brought in by his wife.
He is confused, delirious, and had a seizure before he was brought in.
His wife tells you that he has also had vision changes, and hasn't been able to go to the bathroom for a day now.
"His shrink recently changed his antidepressants..."
PE:
-mouth and mucosa are very dry
-Sinus tachycardia
- the AVR lead exhibits an R wave - unusual
- there is PR interval, QRS, and QT interval elongation
What did this guy likely overdose on?
Tri-cyclic antidepressant (TCA) toxicity
Pt is a 24 yo female, who is brought to the ED after the porch she and her friends were on collapsed. Everyone fell about 15 feet.
Hx: pt landed on her back onto a rock
PE:
Pt cannot move her arms, legs
She is able to breath independently
BP: 84/60
EKG: shows sinus bradycardia
Tx: ABC's
Epi (vasopressor)
Your patient's past medical history includes hypertension, congestive heart failure, diabetes, and seizures. Today, he presents with signs of acute renal failure. Which of his medical problems most likely caused this?
A. Heart failure.
B. Diabetes.
C. Hypertension.
D. Seizures
Heart Failure
Pt is a 7 yo male. He presents with his mom to the ED.
In the last few days, his urine output has majorly increased. He is now dehydrated, despite his mother's efforts.
On top of the diuresis, he is also nauseous, and vomiting a great deal
PE:
Abdomen is very tender
Fruity odor on breath
Kussmaul respiration
DKA
All of the following cranial nerve are responsible for airway control EXCEPT the
Abducens
Pt is a 4 yo female. She is brought in by her mother. The mother reports that she found her daughter after she'd gotten into the medicine cabinet
The child has vomited several times, is dizzy, and says she hears a "ringing"
She had one seizure on the way to the ED
PE:
- Child is sweaty, anxious, and hyperreflexive
Labs:
- Child has respiratory alkalosis, anion gap metabolic acidosis
- hypokalemic
You admit her, and get her IO access and an airway - lucky you did too, as she shortly went into respiratory failure
Salicylate Overdose