FIRST ASSIST
You are dispatched to a nursing home where a 78-year-old female has fallen while getting out of bed. She is conscious but complaining of severe pain in her right hip. There is no visible bleeding or deformity, but the patient is unable to move the leg or stand without severe pain. The nursing home staff reports that she has osteoporosis.
Vital signs upon assessment:
What is your next best step in management?
A) Apply a sling to the affected limb and transport to the hospital
B) Immobilize the hip and leg and prepare for transport to the hospital
C) Attempt to reposition the hip joint to relieve pain
D) Perform a full head-to-toe assessment before immobilizing the leg
B) Immobilize the hip and leg and prepare for transport to the hospital
You are called to a 25-year-old male who was found unresponsive after what bystanders describe as a seizure. The patient is now lying on his side in a recovery position. He has no visible injuries.
Vital signs:
What is your next best step in management?
A) Administer oxygen via non-rebreather mask at 15 L/min
B) Check blood glucose levels to rule out hypoglycemia
C) Place the patient in a head-tilt, chin-lift position to ensure an open airway
D) Initiate rapid transport to the hospital and monitor vital signs
B) Check blood glucose levels to rule out hypoglycemia
Hypoglycemia is a common cause of seizures, particularly in individuals who are diabetic or those who may have not eaten.
You arrive at a construction site where two workers have fallen from a scaffolding. One worker fell from a lower height (about 6 feet), and the other from a much higher elevation (about 20 feet). You have the following patients:
You are dispatched to the scene of a motorcycle crash. The rider is a 35-year-old male who was not wearing a helmet. The bike struck a guardrail, and the rider was thrown from the motorcycle. Upon arrival, the rider is conscious but appears to be in significant pain. There are no visible signs of bleeding, but the patient complains of severe pain in his back and neck.
Vital signs upon assessment:
What is your next best step in management?
A) Maintain C-spine and secure the patient on a long spine board for transport
B) Attempt to take a detailed history from the patient to understand the mechanism of injury before immobilization
C) Place the patient in a sitting position and encourage him to walk to the ambulance
D) Perform a detailed head-to-toe assessment before preparing for transport
A) Maintain C-spine and secure the patient on a long spine board for transport
You are dispatched to the scene of a head-on collision between two vehicles. One of the vehicles has come to a stop against a tree. The driver of the vehicle is a 50-year-old male. Emergency responders on scene have already cut him out of the vehicle, and he is now lying on the ground, conscious but in severe pain. You arrive to assess the situation.
Patient’s Presentation:
Options are:
Apply a sterile dressing to the facial lacerations, immobilize the cervical spine, provide high-flow oxygen, and prepare for rapid transport.
You are called to an office where a 25-year-old male has just been stung by a bee. He has a known bee allergy and carries a epi pen. He is now complaining of difficulty breathing, a scratchy throat, and feeling dizzy. His skin is becoming hives, and his face is swelling.
Vital signs upon assessment:
What is your next best step in management?
A) Administer oxygen and monitor for further signs of improvement
B) Encourage the patient to remain calm and wait for symptoms to resolve on their own
C) Assist the patient with using his epi pen and transport
D) Monitor vitals until further BLS assistance arrive
C) Assist the patient with using his epi pen and transport
You arrive at the scene of an elderly female patient found unresponsive after a fall. The bystanders state that she fell from a standing position. The patient has no visible signs of trauma but is unresponsive.
Vital signs:
A) Administer oxygen via nasal cannula
B) Immobilize the patient’s neck and spine, and prepare for transport
C) Check the patient's blood glucose level
D) Perform a head-tilt, chin-lift maneuver to assess airway patency
B) Immobilize the patient’s neck and spine, and prepare for transport
Given that this patient has fallen and is unresponsive, there’s a concern for possible spinal injury. In elderly patients, falls often result in significant injuries, and even if no trauma is apparent, the possibility of spinal injury cannot be ruled out.
You arrive at a scene where a 50-year-old male is found unresponsive and not breathing. Bystanders report that he collapsed while walking his dog and has a history of heart disease. The patient has no pulse on palpation, and bystanders have started CPR.
What is your next best step in management?
A) Continue CPR and apply the AED as soon as possible
B) Secure the airway and begin ventilating with BVM
C) Begin high-flow oxygen and perform a rapid assessment of the patient’s cardiac rhythm
D) Stop CPR and prepare for transport to the hospital
A) Continue CPR and apply the AED as soon as possible
You are dispatched to the scene of an accident where a pedestrian has been struck by a car. The patient is a 55-year-old male who was hit while crossing the street. Upon arrival, you see that the patient is conscious but in significant pain. His left leg appears severely deformed and displaced, and there is significant bleeding from a laceration over the femur. The car has stopped, and bystanders are assisting.
Vital signs upon assessment:
A) Control bleeding with direct pressure, immobilize the leg, and transport immediately
B) Administer oxygen, check for other injuries, and prepare for rapid transport
C) Apply a tourniquet above the injury site to control bleeding and prepare for transport
D) Attempt to realign the leg to reduce the deformity before immobilization
A) Control bleeding with direct pressure, immobilize the leg, and transport immediately
You arrive at the scene of a head-on collision involving two vehicles. There are four patients involved:
You are called to a workplace where a 45-year-old male with type 1 diabetes is reported to be acting confused and disoriented. His coworkers report that he has not eaten lunch, and they noticed him becoming increasingly shaky and confused over the past 10 minutes.
Vital signs upon assessment:
What is your next best step in management?
A) Administer oxygen via nasal cannula at 2L
B) Assess for any more signs of Hyperglycemia
C) Administer Orange Juice followed by a pack of saltines
D) Administer Oral Glucose
C) Administer Orange Juice followed by a pack of saltines
You arrive at the scene of a 40-year-old male who is found unresponsive by his family. He is known to have a history of substance abuse and was last seen taking drugs in his car.
Vital signs:
What is your next best step in management?
A) Administer naloxone (Narcan) and transport immediately
B) Secure an oral airway and begin ventilating with BVM
C) Administer high-flow oxygen via non-rebreather mask
D) Check the patient's blood glucose level to rule out hypoglycemia
B) Secure an oral airway and begin ventilating with BVM
This patient is likely experiencing a drug overdose (possibly opioids, given the slow respiratory rate and bradycardia). The priority in this situation is to secure the airway and ensure adequate ventilation
You are dispatched to the scene of a high-speed motor vehicle collision. Upon arrival, you find that one of the drivers, a 35-year-old male, was ejected from the vehicle during the crash. He is lying on the ground with no pulse and is unresponsive.
Patient’s Presentation:
Options are:
Begin chest compressions immediately, ensure the airway is clear, and proceed with rapid defibrillation using an AED if indicated.
You arrive at the scene of a high-speed motorcycle crash. The rider was ejected from the bike and landed on the pavement several feet away. There is significant damage to the motorcycle, and the patient is conscious but agitated. Upon assessing the rider, you observe the following:
Patient's Presentation:
Your Options:
Immobilize the patient's spine, provide high-flow oxygen, and prepare for rapid transport while avoiding pressure to the ears.
Scenario 7: Car Accident with Suspected Chest Injury
You are called to the scene of a car accident where a 60-year-old male has been ejected from the vehicle. He is conscious but complaining of severe chest pain and shortness of breath. There is no external bleeding, but the patient has bruising to the chest wall and is in obvious distress.
Vital signs upon assessment:
A) Administer high-flow oxygen, control any bleeding, and prepare for rapid transport
B) Apply a sterile dressing over any visible wounds, immobilize the patient, and transport immediately
C) Administer oxygen via nasal cannula at 8L and perform a full head-to-toe assessment before transport
D) Assume a tension pneumothorax and prepare to needle-decompress the chest
A) Administer high-flow oxygen, control any bleeding, and prepare for rapid transport
You arrive at the scene of a house fire where a 40-year-old female has suffered severe burns to her upper body, including her arms, chest, and face. The patient was rescued from the fire and is now outside, sitting on the ground. She appears to be in severe pain, and you can see blistering and charred skin over the affected areas. She is conscious but extremely anxious.
Vital signs upon assessment:
What is your next best step in management?
A) Apply cool, moist dressings to the burns, and prepare for transport
B) Wrap the patient in a wet sheet to cool the burns
C) Assess the patient’s airway and start high-flow oxygen immediately
D) Remove any smoldering clothing, cool the burns with ice, and transport to the hospital
A) Apply cool, moist dressings to the burns, and prepare for transport
You are dispatched to a home where a 65-year-old male has been found unresponsive by his spouse. The patient has a history of hypertension, atrial fibrillation (AF), and previous transient ischemic attacks (TIAs). The spouse reports that the patient suddenly collapsed while sitting on the couch and has not been responding to verbal stimuli since.
On arrival, the patient is lying supine on the couch, and his spouse states that the patient was complaining of a headache and dizziness shortly before he collapsed. There are no signs of trauma.
Vital signs upon assessment:
A) Administer 100% oxygen via non-rebreather mask and perform a FAST assessment
B) Stabilize cervical spine and place patient on a stair chair for transport
C) Prepare for transport to a stroke center
D) Administer 2L of oxygen via nasal cannula
C) Prepare for transport to a stroke center
You respond to a rollover crash where one passenger has been ejected from the vehicle, and there are three other passengers trapped inside:
You arrive at the scene of a fall from a significant height (about 20 feet) where a 30-year-old male was working on a roof and fell to the ground. The patient is lying on his back, and there are several signs of trauma.
Patient's Presentation:
Options
1. Place the patient in a seated position to aid in breathing and monitor vital signs.
2. Immobilize the patient's spine, provide high-flow oxygen, and address the femur fracture while preparing for rapid transport.
3. Apply direct pressure to the abdominal bruising to control potential internal bleeding.
4. Move the patient into the recovery position to help with breathing and prevent aspiration.
2. Immobilize the patient's spine, provide high-flow oxygen, and address the femur fracture while preparing for rapid transport.
You arrive at the scene of a car accident with three patients:
You are dispatched to a residence where a 55-year-old male is experiencing severe chest pain. He reports that the pain began suddenly while he was watching television and has been constant for the past 15 minutes. He describes the pain as a heavy pressure in the middle of his chest that radiates to his left arm and jaw. He is anxious, and his family is concerned that he may be having a heart attack.
The patient has a history of hypertension, type 2 diabetes, and smoking. He takes medication for high blood pressure but is not currently on medication for diabetes.
What is your next best step in management?
A) Monitor vital signs and prepare for transport
B) Assist patient in taking his prescription of Nitroglycerin
C) Offer the patient some water, assist him to a comfortable position, and wait for symptoms to subside
D) Check patient's blood sugar since he hasn't been on medication for his Type II Diabetes
A) Monitor vital signs and prepare for transport
You arrive at the scene of a 50-year-old male who was found unresponsive in his apartment. The family reports a history of opioid use, and there is a syringe and empty pill bottles nearby. He has not been breathing for several minutes.
Vital signs upon assessment:
A) Administer naloxone (Narcan) and begin ventilating with BVM
B) Begin CPR immediately and call for advanced medical support
C) Administer IV fluids and prepare for rapid transport to the hospital
D) Perform a detailed assessment of the scene and the patient’s history before initiating resuscitation
A) Administer naloxone (Narcan) and begin ventilating with BVM
You arrive at the scene of an industrial explosion at a factory. There are multiple victims, but you can only attend to the first four who are closest to you. These patients have various injuries:
You arrive at the scene of a T-bone collision at a busy intersection. There are three patients: