Why is it Spicy
Snakes on a Plane
Dropped on my own head
ABC's backwards
Aidan & Dylan
100

In a patient with suspected heat stroke, this is the FIRST prehospital intervention that should be initiated immediately on scene.

What is rapid cooling? (Will accept "What is cold/ice water immersion or tarp-assisted cooling?")

100

Proper positioning of a snake bite extremity involves keeping it in this position relative to the heart to slow venom spread.

What is at or slightly below the level of the heart?

100

Following a head injury, this finding—where one pupil is larger than the other—may indicate brain herniation or increased intracranial pressure.

What are unequal pupils (anisocoria)?

100

A patient presents with altered mental status, shallow respirations, and unknown history. This rapid, reversible cause must be assessed first.

What is check blood glucose?

100

What is your red flag? 

Cadet after PT:

  • Complains of fatigue, dizziness
  • Answering questions but slow and slightly confused
  • No collapse

Vitals:

  • HR: 118
  • BP: 104/68
  • RR: 22
  • Skin: warm, dry

Confusion = red flag for heat stroke

200

A patient presents with suspected heat stroke and altered mental status. Oral and tympanic readings are unreliable in this condition. This is the most accurate method to confirm severity and guide treatment in the field.

What is a rectal temperature?

200

This commonly believed field treatment is contraindicated because it worsens tissue damage and does not remove venom.

What is cutting/sucking the wound (or applying a tourniquet)?

200

After an elbow to the jaw, a cadet continues training but later reports difficulty concentrating, mild dizziness, and feeling “foggy.” These symptoms occur despite no direct impact to the skull and are caused by this mechanism of injury.

What is a concussion (indirect mechanism / acceleration-deceleration)?

200

On I-day, a cadet develops headache, fatigue, and mild nausea after arrival, but continues activity. While common, these symptoms represent this condition and require early intervention to prevent progression.

What is acute mountain sickness (AMS)?

200

What is your red flag? 

Cadet found lying down after event:

  • Smells like alcohol
  • Slurred speech
  • Vomited once

Vitals:

  • HR: 64
  • BP: 110/72
  • RR: 10 
  • SpO₂: 93%

Borderline respirations + AMS (airway risk)

300

You respond to a cadet after intense PT. He is confused, staggering, and still sweating, with hot skin. What is the most appropriate diagnosis (without core temp)?

What is exertional heat stroke?

300

During treatment of anaphylaxis, this is the recommended interval for repeating epinephrine auto-injector doses if symptoms persist or worsen.

What is every 5–15 minutes?

300

This physical exam finding, characterized by bruising behind the ears over the mastoid process, suggests a basilar skull fracture.

What is Battle’s sign?

300

A cadet in formation reports lightheadedness, nausea, tunnel vision, and feeling warm, then briefly loses consciousness and rapidly recovers once supine. This type of syncope is most consistent with this mechanism.

What is vasovagal syncope?

300

What is the red flag? 

BCT Cadet:

  • Headache, fatigue
  • Mild nausea
  • No alcohol within 72 hours
  • Still participating

Then:

  • Slight difficulty walking straight

Vitals:

  • HR: 102
  • BP: 128/82
  • RR: 20
  • SpO₂: 91%

What is Ataxia? = neurologic red flag

400

You are treating a heat stroke patient in the field with an initial core temperature of 105°F. You have initiated cold water immersion. What is the target core temperature at which it is considered safe to transition from cooling to transport? 

What is 102°F (≈39°C) 

400

A patient presents several hours after a suspected spider bite with severe muscle cramping, abdominal rigidity, diaphoresis, and hypertension, with minimal local tissue damage at the bite site. This type of envenomation is most likely responsible.

What is a black widow spider bite?

400

Which component of vitals in head injury is often recognized LAST but indicates imminent deterioration? 

What are irregular respirations? 

400

When administering naloxone in the field, the appropriate dose of naloxone is based on what vital sign? 

What is repeat/titrate naloxone doses as needed based on respiratory status? (Note: typically, every ~2–3 minutes per protocol, titrated to respirations) 

400

What is the red flag? 

Cadet in formation:

  • Reports tunnel vision, nausea, feeling hot
  • Did not fully lose consciousness

Now:

  • Feels “better” after sitting
  • Wants to return

Vitals:

  • HR: 88
  • BP: 112/74
  • RR: 16

What is non-exertional pre-syncope? (Why is this a red flag - Diagnostic overlap + risk of recurrence or deterioration)

500

During a field operation, a heat stroke patient with an initial core temp of 106°F has been aggressively cooled using ice sheets and water. The patient is still altered but now begins to shiver, and your rectal temp reads 101.8°F. You are 10 minutes from transport. This is the next best action to prevent worsening complications from overcooling while maintaining appropriate care.

What is stop active cooling and prepare for transport (once ~102°F is reached)?

500

After initial epinephrine, a patient with anaphylaxis improves but then redevelops symptoms 10 minutes later. This phenomenon requires you to be prepared for this repeat intervention.

What is "Biphasic reaction" or "Rebound Syndrome"?

500

In a head injury patient, the combination of bradycardia, irregular respirations, and widening pulse pressure is a late and concerning sign of this condition.

What is increased intracranial pressure (Cushing’s triad)?

500

During Basic Cadet Training, a cadet reports increased thirst, frequent urination, and fatigue over several days, but has continued training. Today, they appear tired, HR: 102, BP: 108/70, RR: 20, Skin: warm, dry but no obvious distress.

What condition should be suspected? 

What is hyperglycemia?

500

Which patient requires immediate EMS activation FIRST?

You are covering an event and evaluating multiple cadets:

Patient A:

  • Pre-syncope in formation
  • Improved after sitting
  • HR 88, BP 112/74

Patient B:

  • Hit to the face 20 minutes ago
  • Now repeating questions, mild headache
  • HR 70, BP 130/80

Patient C:

  • Collapsed during sprint, regained consciousness within seconds. Upon arrival A&Ox4
  • No prodrome symptoms
  • Now alert and “feels fine”
  • HR 82, BP 118/78

Who is Patient C (suspected cardiac syncope)?