Crime Scene Awareness
You respond to a reported assault. Upon arrival, a patient is lying on the sidewalk bleeding, and a crowd is gathered. No law enforcement is present. A bystander states the attacker may still be nearby. What should you do FIRST?
A. Begin hemorrhage control immediately
B. Move the patient to the ambulance
C. Stage until law enforcement secures the scene
D. Quickly assess the patient while remaining alert
C. Stage until law enforcement secures the scene
You are documenting a suspected domestic violence case. Which charting statement is MOST appropriate?
A. “Patient was assaulted by spouse.”
B. “Patient appears abused.”
C. “Patient states spouse struck her repeatedly.”
D. “Injuries are consistent with abuse.”
C. “Patient states spouse struck her repeatedly.”
Which statement reflects the BEST understanding of EMS role in crime scenes?
A. EMS providers collect evidence
B. EMS providers prioritize law enforcement needs
C. EMS providers balance patient care with evidence preservation
D. EMS providers avoid involvement in legal matters
C. EMS providers balance patient care with evidence preservation
A farmer is trapped in machinery with severe bleeding. Extrication will be prolonged. What is your priority?
A. Immediate transport
B. Hemorrhage control during extrication
C. Delay care until extricated
D. Focus on documentation
B. Hemorrhage control during extrication
You are first on scene of a multi-patient crash in a rural area with delayed backup. What is your FIRST priority?
A. Begin treatment of the most critical patient
B. Perform triage and request resources early
C. Transport immediately
D. Wait for additional units
B. Perform triage and request resources early
You are treating a gunshot wound to the chest. You must expose the injury. The patient is wearing a jacket and shirt with visible bullet defects. What is the BEST method?
A. Cut clothing directly through the holes for speed
B. Remove clothing intact if possible, avoiding defects
C. Tear clothing off to minimize time
D. Leave clothing in place and treat around it
B. Remove clothing intact if possible, avoiding defects
You must rapidly extricate a patient from a violent scene. Which action is MOST appropriate regarding evidence?
A. Prioritize evidence preservation over speed
B. Move patient while minimizing scene disruption
C. Wait for law enforcement before moving
D. Avoid touching anything
B. Move patient while minimizing scene disruption
You are the only paramedic on scene with a critically ill patient requiring airway management. Transport time is 35 minutes. What should guide your decision to intubate?
A. Desire to perform advanced skills
B. Protocol mandates
C. Risk vs benefit and transport impact
D. Availability of equipment
C. Risk vs benefit and transport impact
During a call, communication systems fail. You cannot contact medical control. What should you do?
A. Stop all advanced care
B. Continue care under standing orders
C. Return to service
D. Wait until communication resumes
B. Continue care under standing orders
You are managing a cardiac arrest far from definitive care. What intervention has the GREATEST impact on survival?
A. Rapid transport
B. Early CPR and defibrillation
C. Advanced airway placement
D. Medication administration
B. Early CPR and defibrillation
You arrive first at a residence where a patient is found pulseless with lividity and rigor mortis. Family members insist you “do something.” What is the MOST appropriate response?
A. Begin CPR to satisfy family expectations
B. Explain findings and withhold resuscitation
C. Transport immediately
D. Call medical control before acting
B. Explain findings and withhold resuscitation
Still need to contact Medical Control for time of death and to inform of scene.
Which of the following actions is MOST likely to destroy critical forensic evidence?
A. Applying oxygen
B. Cutting through clothing with bullet holes
C. Starting IV access
D. Applying cardiac monitor
B. Cutting through clothing with bullet holes
A patient dies during transport after a suspected homicide. Which action is MOST appropriate upon arrival?
A. Remove all medical equipment
B. Clean blood from the patient
C. Leave all interventions in place
D. Transfer to hospital staff immediately
C. Leave all interventions in place
You suspect organophosphate poisoning in a rural setting. What is your FIRST action?
A. Administer antidotes
B. Secure airway
C. Ensure scene safety and PPE
D. Begin transport
C. Ensure scene safety and PPE
Bonus: Treatment for Organophosphate poisoning?
Severe weather prevents immediate transport of a critical patient. What is your BEST approach?
A. Wait without treatment
B. Provide prolonged field care
C. Cancel transport
D. Move patient outside
B. Provide prolonged field care
During care of a stabbing victim, a police officer asks you what happened. The patient previously stated, “My roommate stabbed me,” but is now unconscious. What should you do?
A. Decline to answer
B. Provide only objective findings
C. Relay the patient’s exact statement
D. Wait for written documentation
C. Relay the patient’s exact statement
A patient with suspicious injuries refuses transport. You suspect human trafficking. What is the BEST course of action?
A. Force transport due to suspicion
B. Respect refusal and leave
C. Document thoroughly and notify appropriate authorities
D. Confront the suspected trafficker
C. Document thoroughly and notify appropriate authorities
Air medical is requested for a trauma patient. Which factor is MOST important in determining feasibility?
A. Distance to hospital
B. Patient condition
C. Weather and landing zone safety
D. Time of day
C. Weather and landing zone safety
You are treating a hypothermic patient with a long transport time. Which action is MOST appropriate?
A. Aggressive rewarming
B. Gentle handling and insulation
C. Rapid movement
D. Immediate defibrillation
B. Gentle handling and insulation
Bonus: At what temperature does the chance of V-fib highly increase with movement?
A rural EMS provider must adapt by:
A. Avoiding high-risk patients
B. Limiting scope of practice
C. Maintaining broad skill competency and autonomy
D. Deferring decisions to hospitals
C. Maintaining broad skill competency and autonomy
A bystander attempts to hand you a firearm used in a shooting. What is the MOST appropriate action?
A. Take the weapon and secure it safely
B. Instruct them to place it down and avoid handling it
C. Place it in a biohazard bag
D. Give it to another responder
B. Instruct them to place it down and avoid handling it
You arrive at a chaotic bar fight scene. Multiple patients, aggressive bystanders, and limited police presence. What is your BEST approach?
A. Enter and begin triage immediately
B. Wait until the scene is completely quiet
C. Stage and request additional law enforcement
D. Remove the first patient you see
C. Stage and request additional law enforcement
You respond to a rollover MVC 40 minutes from the nearest trauma center. The patient is hypotensive with suspected internal bleeding. What is your BEST approach?
A. Perform full stabilization on scene
B. Rapid transport with minimal scene time
C. Wait for ALS intercept
D. Transport to nearest urgent care
B. Rapid transport with minimal scene time
You are treating a STEMI patient 60 minutes from PCI capability. What is MOST appropriate?
A. Delay transport
B. Administer fibrinolytics per protocol
C. Provide oxygen only
D. Wait for ALS backup
B. Administer fibrinolytics per protocol
Bonus: Drugs we use in UH protocol and dosage of drugs?
Which factor MOST contributes to increased mortality in rural EMS systems?
A. Limited training
B. Extended transport times
C. Lower call volume
D. Fewer trauma cases
B. Extended transport times