Patient Assessment
Define the primary assessment order from initial approach to patient priority.
General impression → AVPU/LOC → ABCs → patient priority/transport decision.
How can you determine if an airway is patent upon approach.
Ask "Hello" / look for chest rise and adequate air movement.
What arteries are most likely involved in an MI causing classic chest pain?
Coronary arteries
At what adult fall height is a fall considered severe per common triage guidance?
20 feet
What information should you avoid transmitting during a radio report to the hospital (privacy risk)?
Patient's full name may be excluded or minimized; avoid sending unnecessary PHI over unsecured radio when possible (follow local HIPAA guidance).
What does the mnemonic SAMPLE stand for?
Signs/Symptoms, Allergies, Medications, Past Pertinent Medical History, Last Oral Intake, Events Leading Up
Proper positioning to maintain an airway in a child with decreased consciousness — describe the neutral vs. hyperextended considerations.
Pediatric airway: neutral position with small towel under shoulders; avoid overextension because trachea easily obstructed by head tilt.
What is shock and list three early signs.
Shock = inadequate tissue perfusion; early signs: tachycardia, pale/clammy skin, delayed capillary refill/altered mental status.
Differentiate the "up-and-over" vs "down-and-under" pathways in frontal collisions and common injuries associated with each.
Up-and-over: head strikes windshield (head/neck injury). Down-and-under: knees/hips strike dash (lower extremity/pelvic injuries).
List three principles of proper radio usage in EMS.
Speak slowly and clearly; use plain English (no codes); keep mic 2–3 inches from mouth; pause after transmission; confirm radio is on.
A patient is minimally responsive and cyanotic. List the immediate actions and the rationale in order.
Open airway, assess breathing, begin assisted ventilations with BVM and high-flow O2 if needed, position to protect airway, suction if needed.
Describe indications and a major disadvantage of OPAs.
Indications: unconscious patient without gag reflex. Disadvantage: cannot be used with intact gag reflex (risk of vomiting/aspiration).
Describe the sympathetic "fight-or-flight" physiologic effects relevant to prehospital assessment (heart, vessels, skin, pupils).
Faster/deeper respirations; vasoconstriction raising peripheral resistance; increased heart rate and contractility; diaphoresis; pupillary dilation.
For a T-bone collision where occupant was front passenger, list the most likely kinematics and injuries to check for.
Likely up-and-over with head/facial trauma, possible cervical spine injury; assess airway, C-spine, facial injuries.
Define abandonment in EMS and provide an example from transport scenarios.
Abandonment: initiating care then leaving patient without handing off to equal-or-higher trained provider.
e.g., transport to ED then leaving patient unattended without notifying staff.
How would you report a radial pulse measured as 20 pulsations in 30 seconds; that is barely palpable.
Pulse 40, weak
A patient is breathing 4 shallow breaths/min with a palpable radial pulse and vomited prior to arrival. What is the immediate airway/ventilatory plan?
Clear airway (lateral roll if vomiting but maintain spinal precautions), suction, insert OPA if no gag and ventilate with BVM and supplemental O2.
A patient with chest pain is pale, diaphoretic, with barely audible breath sounds and rapid shallow respirations. What is the first intervention and why?
Assist ventilations with BVM and supplemental oxygen.
Explain the priorities when arriving at a vehicle partially submerged with a trapped victim; include rescuer safety rationale.
Do not enter water unless trained; establish scene safety, summon specialized rescue units, maintain visual/medical care from shore; rescuer safety prevents multiple victims.
When a competent adult refuses transport after being informed of risks, what must you document in the PCR?
Document all care provided, attempts to persuade, risks explained, patient's capacity, signatures on refusal form, and witnesses.
You take an automated BP reading of 280/140 on a noisy scene, what is the next best step and why?
Take a manual blood pressure (auscultation or palpation) to verify automated reading before acting.
Explain how rapid, shallow respirations may reduce minute volume.
Increased rate shortens inspiratory time so alveoli have less time to fill → decreased tidal volume per breath → minute volume may fall.
Minute volume = tidal volume × RR.
Calculate minute volume: tidal volume 350 mL at 28 breaths/min
Minute volume = 350 mL × 28 = 9800 mL/min
Describe how internal hemorrhage leads to need for supplemental oxygen despite an intact airway.
Hemorrhage reduces circulating volume → decreased oxygen-carrying capacity and delivery → supplemental O2 helps maximize oxygen content of remaining blood.
You encounter an oxygen cylinder that is yellow and regulator will not seat. State the safest course of action and explain why.
Remove the yellow cylinder and obtain a correctly color-coded/compatible cylinder (green or service-approved) — do not force regulator; mismatched threads or gas type risk equipment damage or hypoxic/oxidizer mix errors.