EMT: Commonly Missed Questions

While performing chest compressions, where do you want to ensure your hands are located?

The lower half of the breastbone

Inspiration is a/an ________ process causing a _______ pressure in the pleural space

Active/negative

The implementation of a tsunami warning system with monthly drills is known as?

Disaster Mitigation

What is the space in between the vocal cords and the larynx?

Glottic Opening

How often should rescuers switch roles during CPR?

How often should rescuers switch roles during CPR?

Myocardium is the muscle of the heart (my/o = muscle). The thickness of the myocardium is dependent on the function of each heart structure. Which structure of the heart has the thickest myocardial section?

Left ventricle

Your patient is breathing at 12 breaths-per-minute with adequate tidal volume. During inspiration, pressure in the intrapulmonary space is?

Negative compared to atmospheric pressure

How long should you check for a pulse in an unresponsive infant who is not breathing?

No more than 10 seconds

Expiration is a/an ________ process causing a _______ pressure in the pleural space?

Passive/positive

Diffusion is the process by which gases move between the alveoli and which of the following?

Pulmonary capillaries

How do you calculate cardiac output?

Stroke volume x Heart rate

What is the key difference between preeclampsia and eclampsia?

The most significant difference between preeclampsia and eclampsia is seizures. Seizures occur during eclampsia rather than in preeclampsia due to the high levels of proteins.

Preload is an important term in cardiology that refers to?

The force exerted on the ventricle walls at the end of diastole

You are on scene with a 23-year-old female with a femur fracture. She is 5'2" and weighs 130 lbs. When using the Sager splint, what force should be applied?

When applying a Sager traction splint, you should pull traction until you have achieved 10% of the patient's body weight, up to 15 pounds. The patient in this question weighs 130 pounds. Divide that by 10 to get 13 pounds.

The ideal location for a glucose stick on a newborn would be?

When attempting to obtain a glucose check on a newborn, performing a heel stick is preferred. The fingers are too small and don't allow you to get a good grasp.

On inhalation, the diaphragm moves

down

Nonmaleficence

duty to do no harm

You arrive on scene to a bar where a fight has just taken place. A 28-year-old male has been stabbed in the anterior-proximal thigh. What structures, if injured, are the most life threatening?

femoral artery

Kussmaul breathing

gasping, labored breathing, also called air hunger

demand pacemaker

generates pacing impulses only when it senses that the heart's natural pacemaker has fallen below a preset rate.

When giving chest compressions to a newborn, the proper depth of chest compressions is approximately what anteroposterior diameter of the chest?

1/3 to 1/2

Chest compressions should be stopped for no more than how many seconds during CPR?

10 seconds

CO's affinity for hemoglobin compared to oxygen is ________ times greater?

200X GREATER

START triage

A patient sorting process that stands for Simple Triage And Rapid Treatment and uses a limited assessment of the patient's ability to walk, respiratory status, hemodynamic status, and neurologic status.\--> Using START triage, you have four categories: minor (green), delayed (yellow), immediate (red), and deceased (black). The main thing to know with this patient is that they're unconscious, which gets them an "Immediate" status. Don't be lulled into trickery of their airway improving. They're unconscious, they're immediate.

Your 19-year-old female patient is feeling the need to push and is 39 weeks pregnant. She tells you her last baby was born shortly after the start of contractions. She is gravida 2, para 1, and abortion 0. A delivery that occurs within 3 hours from the onset of labor is called?

A precipitous delivery is one that occurs within 3 hours of the onset of labor. If your patient tells you she tends to deliver fast, be prepared to deliver the child in the field or the back of your ambulance.

JumpSTART triage

A sorting system for pediatric patients younger than 8 years or weighing less than 100 lb. There is a minor adaptation for infants since they cannot ambulate on their own.

You're attending a high school football game when you begin assisting with an elderly male in cardiac arrest. The AED analyzes the patient's heart rhythm and gives a "No Shock Advised" message. What should you do next?

AHA guidelines indicate that you continue CPR for 2 minutes. At the end of the two minutes, you'll check for a pulse.

It is a cold winter night and you are called to a 60-year-old male in his apartment. He fell asleep in his bathtub with the outside window wide open. The patient says he is cold, but is not shivering. He is calm, but is confused when answering questions. The ambient temperature in the apartment is warm, about 69 degrees Fahrenheit. His pulse is 52, respirations 10, skin is pale and cold. You should?

Administer oxygen and transport immediately, providing passive re-warming.

You are assessing a 40-week pregnant female patient. She has requested you perform an evaluation and check her vital signs as she is worried about the baby. When you perform your exam, where would you expect to locate the fundus?

At 20 weeks, you should be able to palpate the fundus near the umbilicus. At 40 weeks, you should be able to palpate the fundus near the xiphoid process.

There are two types of valves in the heart. The mitral and tricuspid valves are which kind of valve?

Atrioventricular

When the legs deliver first through the birth canal, it is called?

Breech

A lower airway obstruction occurs in what anatomical structure

Bronchioles

When taking a patient's pulse from this particular site on the body, there is a small risk of hypoperfusion to the brain. Which site has this risk?

Carotid

CHART

Chief Complaint History Assessment Received Treatment Transfer of Care

Burns in children are more serious than in adults. One of the main reasons for this is because?

Children have more skin surface area relative to total body mass compared with adults

main components of a mass casualty incident?

Command, triage, and transportation are the core of what all activities during a mass casualty incident are based on. Maintaining these three components creates a basic framework to help organize the mass casualty incident.

A person with an infectious disease can transmit the disease and infect other people during which stage?

Communicable period

You respond to a patient who stated he was woken from a sound sleep with shortness of breath. Your assessment finds a BP of 180/100, pulse 116, respirations 36 and a pulse oximeter reading of 87%. Lung sounds reveal crackles in the bases. You suspect this patient to be suffering from?

Congestive heart failure- This patient is presenting with classic signs/symptoms of congestive heart failure. Most patients present with shortness of breath, elevated BP and lung sounds with crackles. A lot of patients will have shortness of breath after laying flat while sleeping.

You respond to the scene of a car accident. Your 24-year-old female patient was the restrained driver of a small sedan that was struck from behind. What type of injuries are you most likely to see?

Connective tissue and cervical vertebrae injuries are the most likely injuries in a rear end collision, due to hyperextension followed by hyperflexion. Lateral injuries are most common in side collisions. Leg injuries and upper extremity injuries and fractures are most common in frontal collisions.

Concurrent Medical Direction

Consultation with a physician or other advanced healthcare professional by telephone, radio, or other electronic means, permitting the physician and paramedic to decide together on the best course of action in the delivery of patient care.

PTSD is an example of a(n)?

Delayed Stress Reaction

A 2-year-old child is choking on a piece of her mother's jewelry and her airway is severely obstructed. The proper maneuver to relieve the obstruction is to?

Deliver 5 back blows followed by 5 chest thrusts

You are called to the scene of a rock climbing accident. At the base of the cliff, you find a patient unresponsive and lying on her back. Bystanders tell you she fell on her head from about 35 feet. To assess the patient's airway you should?

Due to the mechanism of injury you should suspect a possible cervical spine injury. Therefore, the patient's head should be stabilized and not tilted. (Use both hands and thrust the patient's jaw forward)

When in utero, the alveoli in a fetus' lungs are filled with?

Fetal lung fluid

You have responded to a fight at a nightclub where police are on scene. Your patient is a 25-year-old male who was struck on the right lateral chest wall by a baseball bat. He is complaining of shortness of breath and "10/10" pain in the area of injury. He has shallow breathing at 30 breaths/minute. Upon inspiration, his right lateral chest wall collapses in. What injury do you suspect your patient

Flail Chest Segment

What is the large opening in the base of the skull where the spinal cord enters?

Foramen magnum

Your 23-year-old female patient just delivered a baby. As you assess the neonate, you note that he is having trouble breathing. You discover his pulse to be 50 bpm, and cyanosis around the lips and fingers. What is your first intervention?

In a neonate, that key number is 60. If their heart rate is below 60, start compressions immediately. If the heart rate is 60-100, assist the patient with ventilations via BVM.

You are off-duty at a local gym when you witness an elderly female collapse. You call out for assistance from the front desk to call 911, grab the AED off the wall, run to her aid, and verify that she is pulseless. How should you proceed?

In a witnessed collapse when an AED is immediately available, the priority is to apply the AED and deliver a shock as soon as possible. In an unwitnessed collapse, or when an AED is not immediately available, we'll start with compressions immediately. Unfortunately, there is no effective way to do compressions and apply an AED, so that one's out.

As you are transporting a pregnant woman to the hospital for labor pains, she becomes lightheaded and dizzy while in the semi-fowlers position on the stretcher. Crowning is not yet present. Your first action should be to?

Instruct the woman to roll over to the left lateral recumbent position

What are the differences between one and two-rescuer infant CPR?

It is important to remember that the compression ratio for one-rescuer CPR is 30:2, using the two fingers in the middle of the chest technique. The ratio for two-rescuer CPR is 15:2, using the two thumbs encircling the middle of the chest technique.

You are called to a bus stop downtown for an elderly male complaining of shortness of breath. Upon arrival, you observe that he is fully responsive, but appears to be sluggish and is having Kussmaul respirations. His skin is warm and dry and you notice a small indentation has been left on his skin from where your hand was. Based on these findings, what would the patient's BGL be?

Kussmaul breathing is a deep, labored breathing pattern commonly seen in patient with Diabetic Ketoacidosis or Hyperglycemia. An average blood glucose reading will range 80-120 mg/dl and although 150 mg/dl is slightly high based on this range, it is not enough to cause these symptoms.

In the human heart, blood flows from the pulmonary veins into the?

Left atrium

Hypoxemia is a condition of?

Low arterial concentration of oxygen

What changes when doing CPR on a victim that is pregnant?

Nothing changes when doing CPR on a pregnant victim. The survivability of the mother and child depend on adequate perfusion, which can only be achieved by proper hand placement, adequate depth, and a rate of 100 - 120 compressions per minutes.

You are responding to an MCI at a multiple crash pileup. Upon arrival, the incident commander assigns you the task of triage officer. You should immediately?

Perform a triage assessment on all patients

The heart wall is made up of all of the following layers, except?

Pericardium

Prospective Medical Direction

Physician development of standards such as training curricula and protocols that establish, in advance, the parameters for EMS practice and set forth the expectations that EMS providers must satisfy in the delivery of patient care.

POLST

Physician order for life sustaining treatment

Which of the following will not be provided by using a pulse oximeter attached to a monitor?

RR

Biot's respirations

Rapid and deep respirations followed by 10 to 30 seconds of apnea

A bus crash has occurred on a nearby interstate and you are among the first to arrive. Upon arriving, you immediately begin rapid triage. What three vitals are used to triage patients?

Respiration, pulse, mental status

You respond to a private residence for a 63-year-old male complaining of shortness of breath. As you place oxygen on the patient, you gather a medical history from the patient's wife who states the patient has a history of cystic fibrosis. Cystic fibrosis is a genetic disorder affecting which two systems?

Respiratory and digestive

body's integumentary system?

Skin, hair, nails, sweat glands

In regards to bone anatomy, what is located at each end of the diaphysis?

The epiphysis is an area at each end of the diaphysis (shaft portion of the bone) that is made of spongy bone. Spongy bone helps to lighten the bone and also houses red bone marrow.

Where is the urethra meatus located in a female?

The external urethral opening (urethral meatus) is located between the clitoris and the vagina.

You have been dispatched to a 12-year-old male with an altered mental status. Parents on scene state that their son began acting funny while watching TV. He got up to go to the bathroom, but walked into the kitchen and then began speaking in incomprehensible sentences. Vital signs are BP: 102/74, HR: 98, RR: 22/min, SpO2: 100% on room air. What is the next intervention you would request from your partner?

This is a tricky question. Checking a capillary blood glucose, ensures you're finding the most quickly reversible life-threat of the answers given. The patient has a 100% oxygen saturation and does not require oxygen therapy. Checking a temperature is a great idea, but you must prioritize it against checking a CBG.

You arrive to find a 30-year-old male patient prone on the ground. Your partner takes c-spine precautions as you turn him supine and notice a portion of the patient's chest wall move opposite directions as he breathes. The patient's family states he fell off the roof while doing construction work. What is the appropriate treatment for your patient's condition?

This patient shows signs of flail chest. Proper treatment includes high-flow oxygen via bag-valve-mask or ET tube. The pressure from ventilation will help adequately oxygenate the patient and stop the paradoxical motion.

The correct sequence of valves when describing the path of blood through the heart is?

Tricuspid, Pulmonary, Mitral, Aortic

The mechanical process of moving air into and out of the lungs is the definition of?

Ventilation

You respond to a multi-vehicle accident. On arrival you notice starring to one of the vehicle's windshield. No airbags were deployed leading you to suspect the starring was caused by?

Whenever starring is noted on a vehicle's windshield, head injury should be assumed until it can be ruled out. Airbag deployment can mimic the classic starring pattern caused by a patient's head hitting the windshield.

preeclampsia

abnormal condition associated with pregnancy, marked by high blood pressure, proteinuria, edema, and headache

Cheyne-Stokes respirations

an abnormal pattern of breathing characterized by periods of apnea followed by deep rapid breathing

oropharynx

central portion of the pharynx between the roof of the mouth and the upper edge of the epiglottis (Upper)

Narrowest part of the pediatric airway

cricoid cartilage

Orthostatic hypotension

low blood pressure that occurs upon standing up

Hypopharynx

tongue (upper)

In which order should you immobilize a patient to a long spinal board?

torso first