Communication
This legal document records patient care and may be used in court.
What is PCR?
Before assisting a patient with a prescribed medication, the EMT confirms the patient's name, verifies the medication belongs to the patient, checks the expiration date, and confirms the correct dose.
Question:
What is the EMT verifying before administering the medication?
The rights of medication administration (patient, medication, dose, route, time, documentation, etc., depending on your program's standard).
This is the most common cause of COPD.
What is smoking?
This is the leading cause of death in adults.
What is heart disease?
Compression depth for an adult.
What is at least 2 inches
You are giving your report to the emergency department. Besides patient information, this communication should include your assessment findings and treatments.
What is a radio or verbal handoff report?
A patient with altered mental status has a blood glucose level of 38 mg/dL. He is unable to swallow and does not respond to verbal commands.
Question:
Should oral glucose be administered?
No. Oral glucose is contraindicated because the patient cannot protect their airway.
A patient with pulmonary edema is anxious, sitting upright, and coughing pink frothy sputum.
Question:
What intervention should the EMT strongly consider if available?
What is CPAP.
Chest pain lasting longer than 20 minutes, associated with diaphoresis and nausea.
What is Acute Coronary Syndrome (ACS)?
Compression rate during adult CPR.
What is 100-120 compressions per minute?
You respond to a patient who speaks very little English. The patient's 10-year-old daughter offers to translate everything for you.
Question:
What is the most appropriate action?
Use a professional interpreter or an approved language translation service whenever possible rather than relying on a child to interpret, while continuing to assess and treat the patient.
A medication causes dilation of blood vessels resulting in decreased blood pressure.
What is vasodilation? (Would accept nitro too)
You respond to a 72-year-old female who has had a productive cough, fever, and increasing shortness of breath for the past four days. She is sitting upright and speaking in full sentences. Vital signs are BP 138/82, HR 108, RR 24, SpO₂ 90% on room air. Lung sounds reveal crackles in the right lower lung field.
Question:
Based on the assessment findings, what respiratory condition is most likely causing this patient's symptoms?
Pneumonia.
A patient has chest discomfort after climbing stairs that resolves with rest.
What is stable angina?
You arrive to find an adult in cardiac arrest. Another rescuer is already performing excellent CPR.
Question:
What should be done next?
Apply the AED as soon as possible.
You respond to a 62-year-old male complaining of dizziness. He is alert and oriented, refuses transport after you explain the risks, and signs the refusal form. Twenty minutes later, his wife calls 911 because he has become unresponsive.
Question:
What documentation from your original encounter will provide the strongest legal protection?
Documentation that the patient had decision-making capacity, the risks of refusing care were explained, questions were answered, vital signs were documented, and the refusal was witnessed and signed.
A patient experiencing chest pain asks if they should take another nitroglycerin tablet because the first one did not relieve the pain.
Question:
What should the EMT do before assisting with another dose?
Reassess vital signs, especially blood pressure, confirm there are no contraindications, and follow local protocol or medical direction.
You respond to a 74-year-old female with difficulty breathing. She is sitting upright, anxious, speaking in two-word sentences, RR 34, BP 182/104, HR 118, SpO₂ 84%. Lung sounds reveal diffuse crackles bilaterally, and she is coughing pink frothy sputum.
Question:
What respiratory emergency is most likely occurring, and what is your priority intervention?
Acute pulmonary edema from congestive heart failure. Apply CPAP if indicated, provide oxygen, monitor closely, and transport rapidly.
You respond to a 58-year-old male with chest pressure that began while mowing the lawn. Skin is cool and diaphoretic. BP 118/74, HR 58, RR 20, SpO₂ 95%. He has no allergy to aspirin, has not taken erectile dysfunction medication, and has his prescribed nitroglycerin.
Question:
What are your treatment priorities?
Administer aspirin, assist with nitroglycerin if appropriate, monitor closely, obtain/request a 12-lead ECG if available, and transport promptly.
You arrive at a grocery store where bystanders have already started CPR on a 55-year-old male. The patient remains pulseless. Your partner places the AED while you continue compressions.
The AED advises, "Shock advised."
Question:
What should your team do next?
Ensure everyone is clear, deliver the shock, immediately resume CPR beginning with chest compressions, and continue for two minutes before the next rhythm analysis.
You transport a 78-year-old female after a fall. In your PCR you write, "Patient was obviously intoxicated and was rude to EMS." During review, your medical director questions the report.
Question:
What should have been documented instead?
Objective findings such as slurred speech, odor of alcohol, unsteady gait, exact patient statements in quotation marks, and observed behaviors—not personal opinions or assumptions.
You are treating a 26-year-old patient with a severe allergic reaction after a bee sting. The patient has audible wheezing, facial swelling, difficulty speaking, BP 82/50, HR 132, and SpO₂ 89%.
Question:
What medication should be administered first, and why?
Intramuscular epinephrine because it rapidly reverses airway swelling, bronchoconstriction, and hypotension. Oxygen and rapid transport should follow.
You arrive for a 19-year-old with a history of asthma. Initially, he has loud wheezing and is speaking one-word sentences. After several minutes, the wheezing suddenly disappears. Respiratory rate is now 10/min with minimal chest rise, SpO₂ is 80%, and the patient is becoming confused.
Question:
What does this change most likely indicate, and what should you do immediately?
Impending respiratory failure due to severe bronchospasm. Begin assisted ventilations with a BVM and high-flow oxygen, administer bronchodilator if available, and transport immediately.
A 64-year-old female complains of chest pain and shortness of breath. She becomes suddenly unresponsive while talking to you. She is apneic and pulseless.
Question:
What is your immediate sequence of care?
Begin high-quality CPR, have a partner retrieve and apply the AED immediately, minimize interruptions in compressions, and follow AED prompts.
You and your partner have been performing CPR on a 68-year-old patient for six minutes. High-quality CPR is ongoing, the AED has delivered two shocks, and the patient suddenly begins moving, opens his eyes, and starts breathing normally.
Vital signs:
Question:
What has most likely occurred, and what are your priorities now?
The patient has achieved return of spontaneous circulation (ROSC). Stop CPR, reassess airway, breathing, and circulation, provide oxygen as needed, monitor closely for deterioration, obtain vital signs, perform a 12-lead ECG if available, and transport rapidly.