DRUGS
SHOCK
GUESS THE DIAGNOSIS
General/ Operations
BLS RESUSCITATION
100

What medication is administered for the treatment of anaphylaxis?

Epinephrine (1:1000)

0.15mg- pediatric 

0.30mg- adult (>30kg)

100

Name 2 of the 3 causes of shock

1) pump failure 

2)poor vessel function

3) low fluid volume 

100

You and your partner are dispatched to a local restaurant for a person having difficulty breathing. Upon arrival, you find a 19-year-old female sitting at a table surrounded by friends. Her friends state she accidentally ate food containing peanuts and has a severe peanut allergy.

The patient appears anxious and is struggling to speak in full sentences. She says her throat feels “tight” and she feels dizzy.

Initial Assessment

  • Airway: Swelling noted to lips and tongue
  • Breathing: Labored with audible wheezing at 30 breaths/min
  • Pulse: 124 beats/min, rapid and weak
  • Skin: Flushed with widespread hives on chest and arms
  • Blood Pressure: 82/48 mmHg
  • SpO₂: 90% on room air
  • LOC: Alert but anxious

Anaphylaxis 

100

What does the L stand for in SAMPLE?

Last know oral intake 

100

What ratio should CPR be administered for two person CPR?

30:2

200

What are the contraindications for the medication Aspirin (ASA)?

Aspirin is an Antiplatelet medication used for treating chest pain.

contraindications

allergy

know hx of liver damage or bleeding disorder 

200

What type of should would you suspect give the following scenario?

You and your partner are dispatched to a motor vehicle collision involving a motorcycle. Upon arrival, you find a 27-year-old male lying on the ground next to the motorcycle. Bystanders state he struck a guardrail and was thrown from the bike.

The patient is conscious but restless and repeatedly asks what happened. There is a large amount of blood coming from a deep laceration on his right thigh.

  • Airway: Patent
  • Breathing: Rapid at 26 breaths/min
  • Pulse: 132 beats/min, weak and rapid
  • Skin: Cool, pale, and clammy
  • Blood Pressure: 88/54 mmHg
  • SpO₂: 94% on room air
  • LOC: Alert but anxious

Hypovolemic shock


large amount of blood loss

200

You and your partner are dispatched to a residence for a 72-year-old male with worsening pedal edema. Upon arrival, you find the patient sitting in a recliner watching television. He appears tired and states that his legs have become “much more swollen” over the past week.

His wife reports a history of Congestive Heart Failure, hypertension, atrial fibrillation, type 2 diabetes, prior myocardial infarction, and chronic kidney disease. She states he normally has mild swelling in his feet, but today the swelling has extended into both lower legs. She also reports he has been less active recently and forgot to take several doses of his prescribed diuretic medication this week.

The patient denies chest pain but says his shoes no longer fit and his legs feel heavy when walking.

Initial Assessment

  • Airway: Patent
  • Breathing: Slightly increased at 22 breaths/min
  • Pulse: 104 beats/min, irregular
  • Skin: Pale and cool
  • Blood Pressure: 168/94 mmHg
  • SpO₂: 93% on room air
  • LOC: Alert and oriented ×4

Congestive heart failure 

200

What is the paperwork called that needs to be filled out every time EMS makes contact with a patient?

Patient Care Report (PCR)

200

Do you need to perform ventilatory assistance to a 56y M patient who has a respiratory rate of 6 but is protecting their airway?

Yes; being able to protect the airway is a positive but the pt is not adequately ventilating 

300

What is the only method EMT-B can administer oral glucose?

oral glucose can be administered orally (PO) if the pt is alert/ can swallow (protect their airway) 

300

What type of shock would you suspect from the following scenario?

You and your partner are dispatched to a private residence for a “sick person.” Dispatch advises that the caller reports fever, weakness, and confusion in a 68-year-old female.

Upon arrival, you find the patient sitting in a recliner covered with blankets. Her daughter states that the patient has had a productive cough and fever for several days and became increasingly confused this morning. The daughter also reports the patient has a history of diabetes and was recently treated for pneumonia.

The patient appears pale, fatigued, and confused. She responds slowly to questions and complains of feeling short of breath and “very weak.”

  • Airway: Patent
  • Breathing: Rapid and shallow at 28 breaths/min
  • Pulse: 124 beats/min, weak
  • Skin: Warm, flushed, and dry
  • Blood Pressure: 84/48 mmHg
  • SpO₂: 90% on room air
  • Temperature: 103.1°F (39.5°C)
  • LOC: Confused, oriented only to person

Septic shock


being treated for pneumonia 

300

You and your partner are dispatched to an assisted living facility for an “altered mental status” in a 79-year-old female. Staff reports that she is usually alert and oriented, but today she has been confused, forgetful, and “not acting like herself.”

Upon arrival, you find the patient sitting in a chair, appearing drowsy and mildly agitated. She is unable to clearly answer questions and repeatedly asks where she is. A caregiver reports the patient has been complaining of burning with urination and increased frequency over the past few days but refused to be evaluated.

Initial Assessment

  • Airway: Patent
  • Breathing: 20 breaths/min, slightly shallow
  • Pulse: 112 beats/min, regular
  • Skin: Warm and dry
  • Blood Pressure: 98/62 mmHg
  • SpO₂: 95% on room air
  • Temperature: 100.8°F (38.2°C)
  • LOC: Confused, oriented only to person

UTI

300

What does the B stand for in DCAPBTLS?

Burns

300

What is the purpose of PEEP?

Assist in the aveoli remaining inflated between rescue breaths so oxygen can be used for gas exchange and not to reinflate the lungs

400

What is the maximum amount of oxygen that can be administered when delivering oxygen via a non-rebreather mask (NRB)?

15 LPM

400

what type of shock would you suspect in their scenario?

You and your partner are dispatched to a reported diving accident at a community pool. Bystanders state that a 22-year-old male dove headfirst into the shallow end and did not immediately resurface. Lifeguards removed him from the water and manually stabilized his head and neck prior to your arrival.

The patient is found lying supine on the pool deck. He is awake but anxious and says, “I can’t feel my legs.” He complains of neck pain and weakness in both arms. There is no major external bleeding noted.

  • Airway: Patent
  • Breathing: Shallow but adequate at 18 breaths/min
  • Pulse: 52 beats/min, weak
  • Skin: Warm, dry, and pink below the chest
  • Blood Pressure: 82/50 mmHg
  • SpO₂: 95% on room air
  • LOC: Alert and oriented ×4

Neurogenic shock


suspected spinal injury

400

You and your partner are dispatched to a college dorm for an “unresponsive person.” Upon arrival, campus security leads you to a 20-year-old male lying on a couch in a shared dorm room. Several empty alcohol bottles and cups are scattered around the room.

Friends report he was drinking heavily at a party and became increasingly drowsy over the past hour. They state he is “not acting right” and is now difficult to wake.

Initial Assessment

  • Airway: Partially patent, gurgling sounds noted
  • Breathing: Slow and irregular at 10 breaths/min
  • Pulse: 58 beats/min, weak
  • Skin: Flushed, warm, and moist
  • Blood Pressure: 102/64 mmHg
  • SpO₂: 92% on room air
  • LOC: Responsive only to painful stimuli
  • Blood glucose: 88 mg/dL
  • Strong odor of alcohol on breath
  • Vomiting noted on clothing and nearby surface

Alcohol intoxication

400

What zone should you position your ambulance when responding to the scene of a potential HazCom?

Green zone


pts will be delivered to you after decontamination

400

What is the AHA recommendation for when you are able to place a mechanical CPR device on a patient?

AHA recommends at least 8 rounds of high quality CPR before assist device is placed

500

After Naloxone has been administered, how fast does the medication wear off?

30-90 minutes 

500

How can you tell the difference between compensated and decompensated shock?

when progressing to decompensated shock that pt will like have…

decreased mental status

decreasing BP (hypotension)

thready/ absent peripheral pulses 

cyanosis

500

You and your partner are dispatched to a grocery store for a possible stroke. Store employees report that a 58-year-old male suddenly began slurring his speech and appeared weak on one side.

Upon arrival, you find the patient sitting against a shelf. He is confused and having difficulty speaking. His right arm appears weak, and the right side of his face is drooping slightly. A family member states the patient has a history of diabetes and takes insulin.

Initial Assessment

  • Airway: Patent
  • Breathing: Normal at 18 breaths/min
  • Pulse: 108 beats/min
  • Skin: Pale, cool, and sweaty
  • Blood Pressure: 138/84 mmHg
  • SpO₂: 98% on room air
  • LOC: Confused and slow to answer questions
  • Blood glucose: 42 mg/dL

Hypoglycemia

500

What is the minimum number of hours required for an EMT-B class?

200 hrs

500

Should you start CPR on a 6 month old pediatric patient who has a pulse of 48 BPM and has respiratory rate of 12 BPM?

Yes; for pediatric patients you start CPR if their HR is <60 BPM regardless of RR but ventilation is always a priority