esi level

60."My sister has metastatic breast cancer, and her doctor suggested that I bring her in today to have more fluid drained off her lungs." The fluid buildup is making it harder for her to breathe. The patient is a cachectic 42-year-old female on multiple medications. Vital signs: T 98.6°F, RR 34, SpO2 95%, HR 92, BP 114/80.

2

67.A 16-year-old male wearing a swimsuit walks into the ED. He explains that he dove into a pool, and his face struck the bottom. You notice an abrasion on his forehead and nose as he tells you that he needs to see a doctor because of tingling in both hands.

2

74."My throat is on fire," reports a 19-year-old female. It started a couple of days ago, and it just keeps getting worse. Now I can barely swallow, and my friends say my voice is different. I looked in the mirror, and I have this big swelling on one side of my throat." No past medical history , no meds, no allergies. Vital signs: T 101.6°F, RR24, HR 92, BP 122/80, SpO2 100% on room air.

2

76.Police escort a disheveled 23-year-old handcuffed male into the triage area. The police report that the patient had been standing in the middle of traffic on the local highway screaming about the end of the world. The patient claims that he had been sent from Mars as the savior of the world. He refuses to answer questions or allow you to take vital signs.

2

79.A young male walks into triage and tells you that he has been shot. As he rolls up the left leg of his shorts, you notice two wounds. He tells you that he heard three shots. He is alert and responding appropriately to questions. Initial Vital signs: T 98.2°F, HR 78, RR 16, BP 118/80.

2

80.An 82-year-old resident of a local assisted living facility called 911 because of excruciating generalized abdominal pain and vomiting that started a few hours ago. The woman is moaning in pain but is still able to tell you that she had a heart attack 6 years ago. Vital signs: T 98°F, RR 28, HR 102, BP 146/80, SpO2 98%. Pain 10/10.

2

84.EMS arrives with a 75-year-old male with a self-inflicted 6-centimeter laceration to his neck. Bleeding is currently controlled. With tears in his eyes, the patient tells you that his wife of 56 years died last week. Health, No known drug allergies, baby ASA per day, BP 136/82, HR 74, RR 18, SpO2, 98% RA.

2

85."My mother is just not acting herself," reports the daughter of a 72-year-old female. She is sleeping more than usual and complains that it hurts to pee." Vital signs: T 100.8°F, HR 98, RR 22, BP 122/80. The patient responds to verbal stimuli but is disoriented to time and place.

2

88."Why the hell don't you just leave me alone?" yells a 73-year-old disheveled male who was brought to the ED by EMS. He was found sitting on the curb drinking a bottle of vodka with blood oozing from a 4-centimeter forehead laceration. He is oriented to person, place, and time and has a Glasgow Coma Scale score of 14.

2

89."This is so embarrassing," reports a 42-year-old male. "We were having incredible sex, and I heard a crack. Next thing you know, my penis was flaccid, and I noticed some bruising." The pain is "unbelievable," 20/10. No meds, No known drug allergies.

2

91.A 20-year-old male presents to the ED after being tackled while playing football. He has an obvious dislocation of his left shoulder and complains of 10/10, severe pain. Neurovascular status is intact, and vital signs are within normal limits.

2

93.A 17-year-old handcuffed male walks into the ED accompanied by the police. The parents called 911 because their son was out of control: verbally and physically acting out and threatening to kill the family. He is cooperative at triage and answers your questions appropriately. He has no past medical history or allergies and is currently taking no medications. Vital signs are within normal limits.

2

17.EMS arrives with a 45-year-old woman with asthma who has had a cold for week. She started wheezing a few days ago and then developed a cough and a fever of 103. Vital signs: T 101.6°F, HR 92, RR 24, BP 148/86, SpO2 97%.

3

19."I think I have food poisoning," reports an otherwise healthy 33-year-old female. "I have been vomiting all night, and now I have diarrhea." The patient admits to abdominal cramping that she rates as 5/10. She denies fever or chills. Vital signs: T 96.8°F, HR 96, RR 16, BP 116/74.

3

20."My migraine started early this morning, and I can't get it under control. I just keep vomiting. Can I lie down somewhere?" asks a 37-year-old female. Past medical history migraines, no allergies. Pain 6/10, T 98°F, RR 20, HR 102, BP 118/62, SpO2 98%.

3

23."I'm 7 weeks pregnant, and every time I try to eat something, I throw up," reports a 27-year-old female. "My doctor sent me to the emergency department because he thinks I am getting dehydrated. T 97°F, RR 18, HR 104, BP 104/68, SpO2 99%. Pain 0/10. Lips are dry and cracked.

3

29.EMS arrives with a 32-year-old female who fell off a stepladder while cleaning her first-floor gutters. She has an obvious open fracture of her right lower leg. She has +2 pedal pulse. Her toes are warm, and she is able to wiggle them. Denies past medical history medications, or allergies. Vital signs are within normal limits for her age.

3

32.A 27-year-old female wants to be checked by a doctor. She has been experiencing low abdominal pain (6/10) for about 4 days. This morning, she began spotting. She denies nausea, vomiting, diarrhea, or urinary symptoms. Her last menstrual period was 7 weeks ago. past medical history: previous ectopic pregnancy. Vital signs: T.98°F, HR 66, RR 14, BP 106/68.

3

33."My right leg is swollen, and my calf hurts," reports a 47-year-old morbidly obese female sitting in a motorized scooter. The patient denies chest pain or shortness of breath, but admits to a history of type 2 diabetes and HTN. Vital signs: T 98°F, RR 24, HR 78, BP 158/82, SpO2 98%. Pain 6/10.

3

36.A 68-year-old female presents to the ED with her right arm in a sling. She was walking out to the mailbox and slipped on the ice. "I put my arm out to break my fall. I was lucky I didn't hit my head." Right arm with good circulation, sensation, and movement, obvious deformity noted. past medical history: arthritis, medications, ibuprofen, No known drug allergies. Vital signs within normal limits. She rates her pain as 6/10.

3

45."It is like I have my period. I went to the bathroom, and I am bleeding. This is my first pregnancy, and I am scared. Do you think everything is OK?" asks a 26-year-old healthy female. Vital signs: BP 110/80, HR 72, RR 18, SpO2 99%, T 98.6°F. She describes the pain as crampy, but rates it as "1" out of 10.

3

47."Our pediatrician told us to bring the baby to the emergency department to see a surgeon and have some tests. Every time I feed him, he vomits and it just comes flying out," reports the mother of a healthy appearing 3�week-old. "None of my other kids did this." Normal vaginal delivery. Vital signs are within normal limits.

3

5.A 41-year-old male involved in a bicycle accident walks into the emergency department with his right arm in a sling. He tells you that he fell off his bike and landed on his right arm. His is complaining of pain in the wrist area and has a 2-centimeter laceration on his left elbow. "My helmet saved me," he tells you.

3

52."My doctor told me to come to the ED. I had a gastric bypass 3 weeks ago and have been doing fine, but today I started vomiting and having this belly pain." The patient, an obese 33-yearold female, rates her pain as 6/10. Vital signs: BP 126/70, HR 76, RR 14, T 98°F.

3

56.EMS arrives with a 42-year-old male who called 911 because of dizziness and nausea every time he tries to move. The patient states, "I feel okay when I lie perfectly still, but if I start to sit up, turn over, or move my head, the room starts to spin and I have to throw up." No past medical history. Vital signs: T 97.2°F, RR 16, HR 90, BP 130/82, SpO2 99%. Pain 0/10.

3

61.A 58-year-old male presents to the emergency department complaining of left lower-quadrant abdominal pain for 3 days. He denies nausea, vomiting, or diarrhea. No change in appetite. past medical history HTN. Vital signs: T 100°F, RR 18, HR 80, BP 140/72, SpO2 98%. Pain 5/10.

3

68.A-25-year-old female presented to the emergency department because of moderate lower abdominal pain with a fever and chills. Two days ago, the patient had a therapeutic abortion at a local clinic. The patient reports minimal vaginal bleeding, Vital signs: T 100.8°F, RR 20, HR 92, BP 118/80, SpO2 99%. Pain 5/10.

3

72.The patient states that she is 6 weeks post laparoscopic gastric bypass. Two days ago, she began to have abdominal pain with nausea and vomiting of pureed food. She reports a decrease in her fluid intake and not being able to take her supplements because of vomiting. Vital signs: T 97.8°F, RR 20, HR 90, BP 110/70, SpO2 99%. Pain 4/10.

3

78."I have been on antibiotics for 5 days for mastitis. I am continuing to nurse my baby, but I still have pain and tenderness in my right breast. Now there is this new reddened area," a 34-year-old new mother tells you. The patient reports having a fever, chills, and just feeling run down. T 102.2°F, RR 20, HR 990, BP 122/80, SpO2 98%. Pain 6/10.

3

8.A normal healthy 7-year-old walks into the emergency department accompanied by his father, who reports that his son woke up complaining of a stomach ache. "He refused to walk downstairs and is not interested in eating or playing." The child vomits at triage. Vital signs: T 100.4°F, RR 22, HR 88, BP 84/60, SpO2100%. Pain 6/10.

3

83."How long am I going to have to wait before I see a doctor?" asks a 27-year-old female with a migraine. The patient is well known to you and your department. She rates her pain as 20/10 and tells you that she has been like this for 2 days. She vomited twice this morning. past medical history: migraines, no allergies, medications include Fioricet.

3

87."I got my belly button pierced a month ago and now it hurts so bad," reports a 19-year-old healthy college student who is accompanied by her roommate. They are chatting about plans for the evening. The area is red, tender, and swollen, and pus is oozing from around the site. Vital signs: T 100°F, HR 74, RR 18, BP 102/70, SpO2 100%. Pain 8/10.

3

98."He was running after his brother, fell, and cut his lip on the corner of the coffee table. There was blood everywhere," recalls the mother of a healthy 19-month-old. "He'll never stay still for the doctor." You notice that the baby has a 2- centimeter lip laceration that extends through the vermilion border. Vital signs are within normal limits for age.

3

13.A 52-year-old female requests to see a doctor for a possible urinary tract infection (UTI). She is complaining of dysuria and frequency. She denies abdominal pain or vaginal discharge. No allergies, takes vitamins, and has no significant past medical history. Vital signs: T 97.4°F, HR 78, RR 14, BP 142/70.

4

21."I cut my finger trying to slice a bagel," reports a 28-year-old healthy male. A 2-centimeter laceration is noted on the left first finger. Bleeding is controlled. Vital signs are within normal limits. His last tetanus immunization was 10 years ago.

4

39."I was using my chainsaw without safety goggles, and I think I got some sawdust in my left eye. It hurts and it just won't stop tearing," reports a healthy 36-year-old male. Vital signs are within normal limits.

4

40."It hurts so much when I urinate," reports an otherwise healthy 25-year-old. She denies fever, chills, abdominal pain, or vaginal discharge. Vital signs: T 98.2°F, HR 66, RR 14, BP 114/60.

4

46.A 42-year-old male presents to triage with a chief complaint of "something in his right eye." He was cutting tree limbs and thinks something went into his eye. No past medical history, no allergies, no medications. On exam, his right eye is reddened and tearing. Pain is 4/10.

4

49."I have had a cold for a few days, and today I started wheezing. When this happens, I just need one of those breathing treatments," reports a 39-year-old female with a history of asthma. T 98°F, RR 22, HR 88, BP 130/80, SpO2 99%, No meds, no allergies.

4

65."I have a fever and a sore throat. I have finals this week, and I am scared this is strep," reports a 19-year-old college student. She is sitting at triage drinking bottled water. No past medical history, medications: birth control pills, no allergies to medications. Vital signs: T 100.6°F, HR 88, RR 18, BP 112/76.

4

70."I was at a family reunion, and we were playing baseball. One of my nephews hit the ball so hard, and I tried to catch it, missed, and it hit me right in the eye. My vision is fine. It just hurts," reports a 34-year-old healthy female. Vital signs are within normal limits. There are no obvious signs of trauma to the globe, only redness and swelling in the periorbital area. The patient denies loss of consciousness.

4

73.A 26-year-old female walks into the triage room and tells you she needs to go into detox again. She has been clean for 18 months but started using heroin again 2 weeks ago when her boyfriend broke up with her. She had called several detox centers but was having no luck finding a bed. She denies suicidal or homicidal ideation. She is calm and cooperative.

4

81."I should have paid more attention to what I was doing," states a 37-year-old carpenter who presents to the ED with a 3-centimeter laceration to his right thumb. The thumb is wrapped in a clean rag. "I know I need a tetanus shot," he tells you. BP 142/76, RR 16, T 98.6°F.

4

86.EMS arrives in the ED with a 57-year-old female with multiple sclerosis. She is bedridden, and her family provides care in the home. The family called 911 because her Foley catheter came out this morning. No other complaints. Vital signs are within normal range, currently on antibiotics for a UTI.

4

9.A 6-year-old male tells you that he was running across the playground and fell. He presents with a 3-centimeter laceration over his right knee. Healthy, no medications and no allergies, immunizations are up to date.

4

90."I have this infection in my cuticle," reports a healthy 26-year-old female. "It started hurting 2 days ago, and today I noticed the pus." The patient has a small paronychia on her right second finger. No known drug allergies. T 98.8°F, RR 14, HR 62, BP 108/70.

4

95.A 63-year-old cachectic male is brought in from the local nursing home because his feeding tube fell out again. The patient is usually unresponsive. He has been in the nursing home since he suffered a massive stroke about 4 years ago.

4

1."I was taking my contacts out last night, and I think I scratched my cornea," reports a 27-year-old female. "I'm wearing these sunglasses because the light really bothers my eyes." Her right eye is red and tearing. She rates her pain as 6/10. Vital signs are within normal limits.

5

18."I have an awful toothache right here," a 38-year-old male tells you as he points to his right lower jaw. "I lost my dental insurance, so I haven't seen a dentist for a couple of years." No obvious swelling is noted. Vital signs are within normal limits. Pain 9/10.

5

26."I have this rash in my groin area," reports a 20-year-old healthy male. "I think it's jock rot, but I can't get rid of it." Using over the counter spray. No known drug allergies. Vital Signs: T 98°F, HR 58, RR 16, BP 112/70.

5

28."I just need another prescription for pain medication. I was here 10 days ago and ran out," a 27-year-old male tells you. "I hurt my back at work, and it's still bothering me." Denies numbness, tingling, or bladder or bowel issues. Vital signs are within normal limits. Pain 10+/10.

5

34."I think my son has swimmer's ear. He spends half the day in the pool with his friends, so I am not surprised," the mother of a 10-year-old boy tells you. The child has no complaints except painful, itchy ears. Vital signs: T 97°F, HR 88, RR 18, BP 100/68.

5

38.Concerned parents arrive in the ED with their 4-day-old baby girl who is sleeping peacefully in the mother's arms. "I went to change her diaper," reports the father, "and I noticed a little blood on it. Is something wrong with our daughter?" The mother tells you that the baby is nursing well and weighed 7 lbs., 2 oz. at birth.

5

4."I ran out of my blood pressure medicine, and my doctor is on vacation. Can someone here write me a prescription?" requests a 56-year-old male with a history of HTN. Vital signs: BP 128/84, HR 76, RR 16, T 97°F.

5

54."I am so embarrassed!" An 18-year-old tells you that she had unprotected sex last night. "My friend told me to come to the hospital because there is a pill I can take to prevent pregnancy." The patient is healthy, takes no medications, and has no allergies. Vital signs: T 97°F, HR 78, RR 16, BP 118/80.

5

55.A 76-year-old male requests to see a doctor because his toenails are hard. Upon further questioning, the triage nurse ascertains that the patient is unable to cut his own toenails. He denies any breaks in the skin or signs of infection. He has a history of chronic obstructive pulmonary disease and uses several metered-dose inhalers. His vital signs are normal for his age.

5

42.A 26-year-old female is transported by EMS to the ED because she experienced the sudden onset of a severe headache that began after she moved her bowels. She is 28 weeks pregnant. Her husband tells you that she is healthy, takes only prenatal vitamins, and has no allergies. On arrival in the ED, the patient is moaning and does not respond to voice. Emergency medical technicians (EMTs) tell you that she vomited about 5 minutes ago.

1

48."I suddenly started bleeding and passing clots the size of oranges," reports a pale 34-year-old who is 10 days post partum. "I never did this with my other two pregnancies. Can I lie down before I pass out?" Vital signs: BP 86/40, HR 132, RR 22, SpO2 98%.

1

51.A 58-year-old male collapsed while shoveling snow. Bystander CPR was started immediately; he was defibrillated once by the paramedics with the return of a perfusing rhythm. The hypothermic cardiac arrest protocol was initiated prehospital, and he presents with cold normal saline infusing.

1

59."Nurse, I have this pressure in my chest that started about an hour ago. I was shoveling that wet snow, and I may have overdone it," reports an obese 52-year-old male. He tells you his pain is 10 out of 10 and that he is nauseous and short of breath. His skin is cool and clammy. Vital signs: BP 86/50, HR 52 and irregular.

1

69.EMS radios in that they are in route with a 17- year-old with a single gunshot wound to the left chest. On scene the patient was alert, oriented and had a BP of 82/palp. Two large-bore IVs were immediately inserted. Two minutes prior to arrival in the ED, the patient's HR was 130 and BP was 78/palp.

1

7."I just turned my back for a minute," cried the mother of a 4-year-old. The child was pulled out of the family pool by a neighbor who immediately administered mouth-to-mouth resuscitation. The child is now breathing spontaneously but continues to be unresponsive. On arrival in the ED, vital signs were: HR 126, RR 28, BP 80/64, SpO2 96% on a non-rebreather.

1

71.A 76-year-old male is brought to the ED because of severe abdominal pain. He tells you, "It feels like someone is ripping me apart." The pain began about 30 minutes prior to admission, and he rates the intensity as 20/10. He has HTN, for which he takes a diuretic. No allergies. The patient is sitting in a wheelchair moaning in pain. His skin is cool and diaphoretic. Vital signs: HR 122, BP 88/68, RR 24, SPO2 94%.

1

92.A 72-year-old female with obvious chronic obstructive pulmonary disease and increased work of breathing is wheeled into triage. Between breaths, she tells you that she "is having a hard time breathing and has had a fever since yesterday." The SpO2 monitor is alarming and displaying a saturation of 79 percent.

1

11.A 4-year-old female is transported to the ED following a fall off the jungle gym at a preschool. A fall of 4 feet. A witness reports that the child hit her head and was unconscious for a couple of minutes. On arrival you notice that the child is crying and asking for her mother. Her left arm is splinted. Vital signs: HR 162, RR 38.

2

35.EMS presents with a 54-year-old female with chronic renal failure who did not go to dialysis yesterday because she was feeling too weak. She tells you to look in her medical record for a list of her current medications and past medical history. Her vital signs are all within normal limits.

2

41."I was smoking a cigarette and had this coughing fit, and now I feel short of breath," reports a tall, thin 19-year-old man. No past medical history, No meds or allergies, Vital signs: T 98°F, HR 102, RR 36, BP 128/76, SpO2 92%. Pain 0/10.

2

43."I think I'm having a stroke," reports an anxious 40-year-old female. "I looked in the mirror this morning, and the corner of my mouth is drooping and I can't close my left eye. You have to help me, please." No past medical history, no meds. Vital signs all within normal limits.

2

44.An 88-year-old female is brought to the ED by EMS. This morning, she had an episode of slurred speech and weakness of her left arm that lasted about 45 minutes. She has a history of a previous stroke, and she takes an aspirin every day. She is alert and oriented with clear speech and equal hand grasps.

2

50."I was seen in the ED last night for my fractured wrist. The bone doctor put this cast on and told me to come back if I had any problems. As you can see, my hand is really swollen and the cast is cutting into my fingers. The pain is just unbearable." Circulation, sensation, and movement are decreased.

2

53."I had a baby 5 weeks ago, and I am just exhausted. I have seen my doctor twice, and he told me I wasn't anemic. I climb the stairs, and I am so short of breath when I get to the top that I have to sit down, and now my ankles are swollen. What do you think is wrong with me?" asks a 23-year-old obese female.

2

57.This patient is the restrained driver of an SUV involved in a high-speed, multicar accident. Her only complaint is right thigh pain. She has a laceration on her left hand and an abrasion on her left knee. Vital signs: BP 110/74, HR 72, RR 16, no medications, no allergies, no past medical history.

2

58."My wife called 911 because my internal defibrillator gave me a shock this morning when I was eating breakfast. Really scared me! I saw my doctor a few days ago, and he changed some of my medications. Could that be why that happened?" The patient has a significant cardiac history and reports taking multiple medications, including amiodarone. Vital signs: T 98.5°F, RR 20, HR 90, BP 120/80.

2

6.A 32-year-old female presents to the emergency department complaining of shortness of breath for several hours. No past medical history, +smoker. Vital signs: RR 32, HR 96, BP 126/80, SpO2 93% on room air, T 98.6°F. No allergies, current medications include vitamins and birth control pills.

2

66."This 84-year-old male passed out in the bathroom," reports the local paramedics. "When we arrived he was in a third-degree heart block with a rate in the 20s and a blood pressure in the 60s. We began externally pacing him at a rate of 60 with an MA in the 50s. He is now alert, oriented, and asking to see his wife."

1

96.A 28-year-old male presents to the ED requesting to be checked. He has a severe shellfish allergy and mistakenly ate a dip that contained shrimp. He immediately felt his throat start to close, so he used his EpiPen. He tells you that he feels okay. No wheezes or rash noted. Vital signs: BP 136/84, HR 108, RR 20, SpO2 97%, T 97°F.

2

99.A 44-year-old female is retching continuously into a large basin as her son wheels her into the triage area. Her son tells you that his diabetic mother has been vomiting for the past 5 hours, and now it is "just this yellow stuff." "She hasn't eaten or taken her insulin," he tells you. No known drug allergies. Vital signs: BP 148/70, P 126, RR 24.

2

12.A 60-year-old man requests to see a doctor because his right foot hurts. On exam the great toe and foot skin is red, warm, swollen, and tender to touch. He denies injury. past medical history includes type 2 diabetes, and psoriasis. Vital signs: T 99.4°F, RR 18, HR 82, BP 146/70, SpO2 99%.

3

15."My right breast is so sore, my nipples are cracked, and now I have a fever. Do you think I will have to stop nursing my baby?" asks a tearful 34-year-old female. She is 3 months post partum and has recently returned to work parttime. Vital signs: T 102.8°F, HR 90, RR 18, BP 108/60, pain 5/10. No past medical history, taking multivitamins, and is allergic to penicillin.

3

24."I have this aching pain in my left leg," reports an obese 52-year-old female. "The whole ride home, it just ached and ached." The patient tells you that she has been sitting in a car for the last 2 days. "We drove my daughter to college, and I thought it was the heat getting to me." She denies any other complaints. Vital signs: BP 148/90, HR 86, RR 16, T 98°F.

3

31.A healthy middle-aged man presents to the emergency department with his left hand wrapped in a bloody cloth. "I was using my table saw, and my hand slipped. I think I lost of couple of fingertips." No past medical history, no med or allergies. Vital signs are within normal limits. Pain 6/10.

3

75."My doctor told me to come to the ED. He thinks my hand is infected," a 76-year-old female with arthritis, chronic renal failure, and diabetes tells you. She has an open area on the palm of her hand that is red, tender, and swollen. She hands you a list of her medications and reports that she has no allergies. She is afebrile. Vital signs: HR 72, RR 16, BP 102/60.

3

10."I slipped on the ice, and I hurt my wrist," reports a 58-year-old female with a history of migraines. There is no obvious deformity. Vital signs are within normal limits, and she rates her pain as 5/10.

4

62."I think he has another ear infection," the mother of an otherwise healthy 2-year-old tells you. "He's pulling on his right ear." The child has a tympanic temperature of 100.2°F and is trying to grab your stethoscope. He has a history of frequent ear infections and is currently taking no medication. He has a normal appetite and urine output, according to the mother.

5

63."My son needs a physical for camp," an anxious mother tells you. "I called the clinic, but they can't see him for 2 weeks and camp starts on Monday." Her son, a healthy 9-yearold, will be attending a summer day camp.

5

64."Last night I had sex, and we used a condom but it broke. I just don't want to get pregnant," a teary 18-year-old female tells you. Vital signs are within normal limits.

5

77."My dentist can't see me until Monday, and my tooth is killing me. Can't you give me something for the pain?" a healthy 38-year-old male asks the triage nurse. He tells you the pain started yesterday, and he rates his pain as 10/10. No obvious facial swelling is noted. Allergic to penicillin. Vital signs: T 99.8°F, HR 78, RR 16, BP 128/74.

5

82."My son woke me up about 3 hours ago complaining of a right earache. I gave him some acetaminophen but it didn't help," the 4-year-old's mother tells you. No fever, other vital signs within normal limits for age.

5

94."I think I need a tetanus shot," a 29-year-old female tells you. "I stepped on a rusty nail this morning, and I know I haven't had one for years." No past medical history, No known drug allergies, no medications.

5

97.You are trying to triage an 18-month-old whose mother brought him in for vomiting. The toddler is very active and trying to get off his mother's lap. To distract him, the mother hands him a bottle of juice, which he immediately begins sucking on. The child looks well hydrated and is afebrile.

5

3.EMS arrived with an unresponsive 19-year-old male with a single self-inflicted gunshot wound to the head. Prior to intubation, his Glasgow Coma Scale score was 3.

1

14."I called my pediatrician, and she told me to bring him in because of his fever," reports the mother of a 2-week-old. Vital signs: T 101°F, HR 154, RR 42, SpO2 100%. Uncomplicated, vaginal delivery. The baby is acting appropriately.

2

25.EMS arrives with an 87-year-old male who fell and hit his head. He is awake, alert, and oriented and remembers the fall. He has a past medical history of atrial fibrillation and is on multiple medications, including warfarin. His vital signs are within normal limits.

2

27.EMS arrives with a 17-year-old restrained driver involved in a high-speed motor vehicle crash. The patient is immobilized on a backboard and is complaining of abdominal pain. He has multiple lacerations on his left arm. Vital signs prior to arrival: BP 102/60; HR 86, RR 28, SpO2 96%.

2

100.EMS arrives with a 76-year-old male found on the bathroom floor. The family called 911 when they heard a loud crash in the bathroom. The patient was found in his underwear, and the toilet bowl was filled with maroon-colored stool. Vital signs on arrival: BP 70/palp, HR 128, RR 40. His family tells you he has a history of atrial fibrillation and takes a "little blue pill to thin his blood."

1

16.Paramedics arrive with a 16-year-old unrestrained driver who hit a tree while traveling at approximately 45 miles per hour. The passenger side of the car had significant damage. The driver was moaning but moving all extremities when help arrived. His initial vital signs were BP 74/50, HR 132, RR 36, SPO2 99%, T 98.6°F.

1

2.EMS presents to the ED with an 18-year-old female with a suspected medication overdose. Her college roommates found her lethargic and "not acting right," so they called 911. The patient has a history of depression. On exam, you notice multiple superficial lacerations to both wrists. Her respiratory rate is 10, and her SpO2 on room air is 86 percent.

1

22."The smoke was so bad; I just couldn't breathe." reports a 26-year-old female who entered her burning apartment building to try to rescue her cat. She is hoarse and complaining of a sore throat and a cough. You notice that she is working hard at breathing. History of asthma; uses inhalers when needed. No known drug allergies. Vital signs: T 98°F, RR 40, HR 114, BP 108/74.

1

30.The medical helicopter is en route to your facility with a 16-year-old male who was downhill skiing and hit a tree. Bystanders report that he lost control and hit his head. He was intubated at the scene and remains unresponsive.

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37."I just don't feel right," reports a 21-year-old female who presented in the ED complaining of a rapid heart rate. "I can barely catch my breath, and I have this funny pressure feeling in my chest." HR is 178 and regular, RR 32, BP 82/60. Her skin is cool and diaphoretic.

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