Show:
FIRST ASSIST
UNRESPONSIVE
DISPATCH MISHAPS
TRAUMA
10-50 PI
100

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:

  • Respiratory rate: 18 breaths per minute
  • Pulse: 92 beats per minute
  • Blood pressure: 130/80 mmHg

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

100

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:

  • Respiratory rate: 16 breaths per minute
  • Pulse: 88 beats per minute
  • Blood pressure: 120/78 mmHg
  • Oxygen: 95%

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.

100

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:

  • Patient A: A 25-year-old male who fell from a height of 6 feet, complaining of severe lower back pain and difficulty moving his legs.
  • Patient B: A 35-year-old male who fell from a height of 20 feet, unconscious, with a significant head injury, bleeding from the ears, and multiple fractures in both legs.
  • First Priority: Patient B – Secure the airway, provide cervical spine immobilization, and prepare for rapid transport. Address the head injury and monitor for signs of worsening neurological status.
  • Second Priority: Patient A – Stabilize the back and neck, assess for neurological deficits, and transport carefully to prevent further injury.
100

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:

  • Respiratory rate: 26 breaths per minute
  • Pulse: 122 beats per minute 
  • Blood pressure: 110/70 mmHg

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

100

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:

  • Conscious but confused, with a Glasgow Coma Scale (GCS) of 14 (eye-opening 4, verbal response 4, motor response 6).
  • Severe facial trauma: Deep lacerations to the face, bleeding from the mouth and nose, with signs of dental injury (missing teeth).
  • Deformity of the left leg (significant angulation at the femur, likely fracture with possible open wound).
  • Painful, shallow breathing and abdominal distention with tenderness on palpation.
  • Hypotension (blood pressure 80/50 mmHg), tachycardia (heart rate 120 bpm), and cool, clammy skin, suggesting hypovolemic shock.
  • Bruising around the chest and upper abdomen.

Options are:

  • Place the patient in the recovery position to improve his breathing and reduce risk of aspiration.
  • Apply a sterile dressing to the facial lacerations, immobilize the cervical spine, provide high-flow oxygen, and prepare for rapid transport.
  • Palpate the abdomen for further injuries and apply pressure to control any internal bleeding from the abdomen.
  • Immediately perform a field amputation of the femur to avoid further complications from the fractured leg.

Apply a sterile dressing to the facial lacerations, immobilize the cervical spine, provide high-flow oxygen, and prepare for rapid transport.

200

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:

  • Respiratory rate: 22 breaths per minute 
  • Pulse: 110 beats per minute 
  • Blood pressure: 90/60 mmHg 
  • Oxygen: 89%

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

200

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:

  • Respiratory rate: 14 breaths per minute
  • Pulse: 56 beats per minute
  • Blood pressure: 110/70 mmHg
  • Oxygen: 91% 

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.

200

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

200

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:

  • Respiratory rate: 18 breaths per minute
  • Pulse: 110 beats per minute 
  • Blood pressure: 100/60 mmHg 
  • Oxygen: 91%

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

200

You arrive at the scene of a head-on collision involving two vehicles. There are four patients involved:

  • Patient A: A 30-year-old male, unconscious with significant facial trauma, a bleeding scalp laceration, and difficulty breathing.
  • Patient B: A 45-year-old female, conscious but complaining of severe chest pain, shortness of breath, and shoulder tenderness.
  • Patient C: A 60-year-old male, semi-conscious with a deformity in his right leg, massive bruising on the chest, and abdominal pain.
  • Patient D: A 25-year-old female, conscious and alert with a fractured arm, minor neck pain, and no visible bleeding.
  • First Priority: Patient A – Stabilize the airway and breathing and monitor for signs of head or neck injury.
  • Second Priority: Patient B – Manage chest pain and shortness of breath, and provide oxygen.
  • Third Priority: Patient C – Address the chest and abdominal injuries, possibly controlling bleeding and stabilizing the leg for transport.
  • Fourth Priority: Patient D – Immobilize the fractured arm.
300

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:

  • Respiratory rate: 11 breaths per minute
  • Pulse: 88 beats per minute 
  • Blood pressure: 120/80 mmHg
  • Blood glucose: 35 mg/dL
  • Oxygen: 92%

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

300

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:

  • Respiratory rate: 5 breaths per minute 
  • Pulse: 48 beats per minute 
  • Blood pressure: 90/60 mmHg
  • Oxygen: 78%

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

300

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:

  • Unresponsive and no breathing.
  • No pulse upon palpation.
  • The patient was initially conscious when emergency responders arrived, but he collapsed shortly after, with no signs of breathing or pulse when you check.
  • The scene is chaotic, with other patients in need of care, but this patient is clearly in cardiac arrest.
  • The patient’s vehicle struck a tree at high speed, suggesting significant trauma.

Options are:

  • Begin chest compressions immediately, ensure the airway is clear, and proceed with rapid defibrillation using an AED if indicated.
  • Check for any signs of life and wait for additional responders to assist before starting CPR.
  • Move the patient to a safer location before starting chest compressions to avoid further injury.
  • Administer high-flow oxygen and monitor for any signs of return of spontaneous circulation (ROSC) without starting CPR.

Begin chest compressions immediately, ensure the airway is clear, and proceed with rapid defibrillation using an AED if indicated.

300

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:

  • Age: 28-year-old male
  • Conscious but confused and disoriented 
  • Facial trauma with a laceration to the forehead.
  • Drainage from both ears: clear fluid with a slight blood tint.
  • Neck pain with limited range of motion.
  • Bruising around the eyes (raccoon eyes).
  • Signs of shock: rapid, weak pulse (tachycardic), low blood pressure, and cold, clammy skin.
  • Painful breathing with severe chest tenderness when palpated.

Your Options:

  1. Immediately insert an oropharyngeal airway (OPA) to open the airway and relieve any potential airway obstruction caused by facial trauma.
  2. Place the patient in a sitting position to help with breathing and manage their pain.
  3. Apply pressure to the ears to stop the drainage of cerebrospinal fluid.
  4. Immobilize the patient's spine, provide high-flow oxygen, and prepare for rapid transport while avoiding pressure to the ears.

Immobilize the patient's spine, provide high-flow oxygen, and prepare for rapid transport while avoiding pressure to the ears.

300

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:

  • Respiratory rate: 22 breaths per minute 
  • Pulse: 110 beats per minute
  • Blood pressure: 90/50 mmHg
  • Oxygen 83%

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

400

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:

  • Respiratory rate: 20 breaths per minute (normal)
  • Pulse: 120 beats per minute (tachycardic)
  • Blood pressure: 90/60 mmHg 
  • Oxygen: 94%

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

400

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:

  • Respiratory rate: 14 breaths per minute
  • Pulse: 110 beats per minute 
  • Blood pressure: 180/110 mmHg
  • Oxygen saturation: 92% on room air

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


400

You respond to a rollover crash where one passenger has been ejected from the vehicle, and there are three other passengers trapped inside:

  • Patient A: A 28-year-old male who was ejected from the vehicle, unconscious, with multiple abrasions on the face, and a suspected spinal injury.
  • Patient B: A 30-year-old female, conscious with difficulty breathing and bruising to the chest and abdomen.
  • Patient C: A 40-year-old male, conscious but complaining of severe pain in the pelvis and right leg, unable to move his leg.
  • Patient D: A 50-year-old male, semi-conscious with a massive open wound on his left thigh and severe bleeding.
  • First Priority: Patient D – Control the severe bleeding to prevent shock or death.
  • Second Priority: Patient A – Secure the airway, spinal immobilization, and address any life-threatening trauma.
  • Third Priority: Patient B – Manage breathing and potential internal injuries, providing oxygen and stabilizing for transport.
  • Fourth Priority: Patient C – Immobilize the pelvis and leg, and manage pain once the more critical patients are addressed.
400

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:

  • Conscious but confused, with a Glasgow Coma Scale (GCS) score of 14 (eye-opening 3, verbal response 4, motor response 7).
  • Severe pain in the lower back, with noticeable deformity and swelling.
  • Obvious deformity of the right leg (deformed thigh and knee, with possible femur fracture).
  • Bruising around the abdomen and distention (indicating possible internal bleeding).
  • Painful, shallow breathing with crackling sounds when palpating the chest.
  • Hypotension (blood pressure 90/60 mmHg) and tachycardia (heart rate 125 bpm).
  • Cold, clammy skin, profuse sweating, and signs of shock.

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.

400

You arrive at the scene of a car accident with three patients:

  • Patient A: A 32-year-old male with a crushed leg, severe bleeding from the thigh, and difficulty breathing.
  • Patient B: A 50-year-old female with a suspected neck injury, complaining of chest pain, and appears confused.
  • Patient C: A 22-year-old male with a large forehead laceration, no obvious signs of distress, and is conscious and alert.


  • First Priority: Patient A – Stop the bleeding and address any immediate life-threatening airway or breathing issues.
  • Second Priority: Patient B – Stabilize the neck and manage potential cardiac or respiratory issues.
  • Third Priority: Patient C – Monitor for any hidden head injuries and address the laceration.
500

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.

  • Respiratory rate: 18 breaths per minute 
  • Pulse: 105 beats per minute 
  • Blood pressure: 150/90 mmHg
  • SpO2: 97% 

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

500

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:

  • Respiratory rate: 0 breaths per minute
  • Pulse: 39 beats per minute
  • Blood pressure: 70/50 mmHg

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


500
  • Patient A: A 25-year-old female, conscious but pinned under a heavy beam, complaining of severe back pain and difficulty breathing.
  • Patient B: A 40-year-old male, unconscious with a large head wound, slow pulse, and shallow breathing.
  • Patient C: A 60-year-old male, conscious but very pale, with an open chest wound and difficulty breathing.
  • Patient D: A 30-year-old female, conscious, complaining of a fractured leg and mild bleeding from the arm.


  • First Priority:Patient B – Stabilize the airway and circulation, and monitor for neurological deterioration. 
  • Second Priority: Patient C – Address the open chest wound and difficulty breathing to prevent respiratory failure or collapse.
  • Third Priority: Patient A – Manage breathing and spinal precautions.
  • Fourth Priority: Patient D – Stabilize the fracture and minor bleeding after addressing life-threatening issues.
500

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:

  • Patient A: A 50-year-old male who is conscious but complaining of severe burns to both hands and appears anxious and disoriented.
  • Patient B: A 28-year-old female, unconscious with a shallow, irregular pulse and significant burns over 50% of her body, including the face.
  • Patient C: A 40-year-old male, with massive shrapnel wounds to the abdomen, severe bleeding, and a rapid, weak pulse.
  • Patient D: A 30-year-old female, conscious with severe lacerations across her chest and neck but with normal vital signs.
  • First Priority: Patient C – Control the bleeding, stabilize for shock, and manage airway. Rapid transport is critical.
  • Second Priority: Patient B – Secure the airway, provide oxygen, and begin fluid resuscitation for the burn shock.
  • Third Priority: Patient D – Manage the lacerations and assess for any hidden internal injuries.
  • Fourth Priority: Patient A – Treat the burns on the hands and address pain, ensuring the patient’s airway is not compromised.
500

You arrive at the scene of a T-bone collision at a busy intersection. There are three patients:

  • Patient A: A 35-year-old female with a severe contusion on the chest, shortness of breath, and decreased breath sounds on the left side.
  • Patient B: A 20-year-old male, conscious but confused, with a laceration to the scalp and pain in the lower abdomen.
  • Patient C: A 50-year-old male, unconscious with a compound fracture of the left femur, bruising on the face, and shallow breathing.
  • First Priority: Patient A – Address the chest injury, stabilize breathing, and prepare for potential transport of a pneumothorax or hemothorax.
  • Second Priority: Patient C – Stabilize the airway, provide spinal precautions, and manage the compound fracture.
  • Third Priority: Patient B – Assess the level of consciousness and internal injuries, and monitor airway and breathing while preparing for transport.