Q&A Hero

Q: In cases of extreme hypothermia, you will find the patient unconscious, with no discernible vital signs, and skin cold to your touch with stiff joints as if they appear dead. What is the emergency care for these patients? A) Contact medical control for input into the best treatment for this patient. B) Call the coroner as indications are the patient is cold and deceased, which is a definitive sign of death. C) Check distal CSM, apply warming packs to the extremities, and transport the patient. D) Assess the carotid pulse for 30 to 45 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED.

Q: You respond to the scene of a 14-year-old patient. He is unresponsive and hypothermic. Emergency Medical Responders have moved the patient inside and secured the airway prior to your arrival. What is your next action? A) Vigorously rub the patient to increase the body temperature. B) Actively rewarm the patient. C) Passively rewarm the patient. D) Assess for signs of frostbite and treat immediately.

Q: You respond to a landing zone to pick up a skier who was lost in the woods for 36 hours and found by the search and rescue helicopter. Your patient is a 19-year-old male patient. He is alert and oriented to time, person, place, and event. He is covered in blankets and shivering. He complains of not being able to feel his fingers. Physical exam reveals that the fingers of both extremities have a waxy appearance and feel "frozen" on the surface. After treating the patient for potential hypothermia and rapid transport, your next action is to: A) bandage the digits. B) actively rewarm the digits. C) gently warm the digits by slowly massaging them. D) keep the digits frozen on ice until they can be properly rewarmed at the hospital.

Q: You are on a stand-by at a local high school football game. One of the football players comes over to the ambulance and complains that his face feels numb and that he has a burning sensation in his fingers. You notice that the patient's cheeks and fingers are bright red. How should you treat the patient? A) Allow the patient to warm up inside the ambulance by passive rewarming measures. B) Place the patient inside the ambulance and begin active rewarming measures. C) Warm the affected areas with gentle rubbing. D) Tell the patient that his condition is superficial and allow him to return to the game.

Q: When resuscitating a hypothermic patient in cardiac arrest, resuscitation attempts must continue until the patient has: A) been ventilated for at least 30 minutes with an oropharyngeal airway (OPA) in place. B) developed rigor mortis. C) been defibrillated a total of nine times. D) been rewarmed.

Q: Why is it important to keep patients at rest when they are hypothermic? A) Since the blood is warmest in the extremities, exercise or unnecessary movement could quickly circulate the warm blood and raises the core body temperature. B) Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and drop the blood pressure. C) Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature. D) None of the above

Q: To assess skin temperature for a possibly hypothermic patient, the EMT should place the back of his hand against which part of the patient's body? A) Forehead B) Cheek C) Abdomen D) Inner wrist

Q: The technique for central rewarming requires the application of heat to which of the following areas of the patient's body? A) Chest, back, neck, and armpits B) Lateral chest, neck, armpits, and groin C) Head, neck, chest, and back D) Head, neck, chest, and groin

Q: When actively rewarming a frostbitten extremity in warm water, you should change the water when the temperature falls below ________ F. A) 115 to 120 B) 100 to 105 C) 85 to 95 D) 80 to 90

Q: Which of the following is acceptable when actively rewarming a hypothermic patient? A) Encouraging the patient to exercise B) Giving coffee or brandy to drink C) Warming the patient as quickly as possible D) Applying humidified oxygen

Q: Allowing a patient's body temperature to increase by preventing further heat loss is referred to as which of the following? A) Core rewarming B) Passive rewarming C) Active rewarming D) Natural rewarming

Q: Why is it important to remove constricting items such as rings before thawing a frozen extremity? A) Because thawed areas often swell B) To prevent damage to the property such as rings and watches C) Because thawing leaves clots behind in the veins D) All of the above

Q: Which of the following would you expect to see in a patient with severe hypothermia? A) Irrational behavior B) Loss of muscle tone C) Rapid respirations D) Tachycardia

Q: Which of the following signs would you NOT expect to see in a patient suffering from severe hypothermia? A) Numbness B) Shivering C) Drowsiness D) Skin cool to touch

Q: Who is the most susceptible to hypothermia? A) 21-year-old near-drowning patient on a warm spring day B) 55-year-old male patient who sprained his knee snow skiing C) 76-year-old male patient involved in a vehicle accident on icy roads D) 80-year-old male patient on the ground who slipped and has a hip fracture

Q: Why are infants and young children more prone to hypothermia than adults? A) Their immune system is not fully developed. B) They are unable to recognize how cold they are. C) They shiver more than adults. D) They have less fat than adults.

Q: For which of the following reasons are newborns, infants, and the elderly more readily affected by the heat than other age groups? A) Faster metabolism B) Increased body mass C) Inadequate salt intake D) Poor ability to regulate body temperature

Q: Which of the following does NOT make infants and children more prone to hypothermia? A) Inefficient metabolism B) Large body surface area C) Small muscle mass D) Little body fat

Q: Which of the following terms describes the temperature of the surrounding air? A) Wind chill index B) Shell temperature C) Core temperature D) Ambient temperature

Q: When the body is in water, how many times faster does it lose heat than when it is in still air? A) 2 B) 100 C) 10 D) 25

Q: Most radiant heat is lost through which part of the body? A) Hands and feet B) Head C) Buttocks D) Torso

Q: Which of the following is the most significant way in which the body cools itself? A) Respiration B) Perspiration C) Radiation D) Vasoconstriction

Q: In which of the following ways does the body produce heat in response to being cold? A) Excreting more urine B) Burning fewer calories C) Shivering D) Increasing the respiratory rate

Q: A patient who is lying on cold ground is losing the most amount of heat by what mechanism? A) Radiation B) Convection C) Conduction D) Shivering

Q: Applying an external source of heat to the patient's body to rewarm him is called ________ rewarming. A) central B) active C) endogenous D) peripheral

Q: Which of the following is the process in which heat is lost from the body as wind passes over it? A) Convection B) Hydrodynamic cooling C) Exposure D) Condensation

Q: In which of the following situations would a person lose heat by conduction? A) Sitting on cold metal bleachers at a football game B) Wearing wet clothing in windy weather C) Breathing D) Going outside without a coat during a cold but calm day

Q: Reducing the pain of a marine animal sting can be accomplished by rinsing the affected area with which of the following? A) Sterile saline solution B) Gasoline or kerosene C) Cold water D) Vinegar

Q: Which of the following types of snake is NOT a pit viper? A) Water moccasin B) Rattlesnake C) Coral snake D) Copperhead

Q: Which of the following could worsen the effects of a snake bite? A) Application of ice B) Cutting and suctioning out the venom C) Constricting bands above and below the bite D) Having the patient lie still

Q: Of the following venomous snakes, which one usually has the highest incidence of a "dry bite?" A) Coral snake B) Water moccasin C) Mississauga rattlesnake D) Copperhead

Q: The purpose of a constricting band after a venomous snake bite is to impede the flow of which of the following? A) Lymph B) Arterial blood C) Venom D) Both A and C

Q: Where should a constricting band be placed to reduce lymphatic flow after a venomous snake bite? A) 2 inches above the bite B) 2 inches below the bite C) 2 inches above and 2 inches below the bite D) None of the above

Q: You respond to a farm for a possible snake bite. You find a 36-year-old male patient seated against a tree. Bystanders state the patient was bitten on the arm by a rattlesnake and is "really sick." As you approach, you notice that the patient appears in obvious distress, diaphoretic, and holding his right wrist. Which of the following is your highest priority? A) Perform a primary assessment and identify any potential life threats. B) Confirm the type of snake and contact medical control for specific instructions. C) Immediately apply a constricting band to minimize the spread of the venom. D) Confirm the location and status of the snake.

Q: You respond to the scene of a local campground. Your patient is a 15-year-old female patient who was stung in the arm by a bee. The patient is anxious and hyperventilating at 28 times a minute. The patient is alert and oriented to time, place, person, and event. Lung sounds are clear bilaterally. The left arm is swollen and the stinger is not present. Blood pressure is 118/72 and pulse is 110. The patient's mother states she is allergic to bee stings and has an epinephrine auto-injector. She called 911 because she was afraid the patient would stop breathing. Which of the following is the best treatment plan? A) Place a constricting band around the arm to minimize the spread of the venom. B) Assist the patient in administering her epinephrine auto-injector. C) Monitor the patient for shock and transport. D) Place the patient in the Trendelenburg position.

Q: Which of the following is acceptable in the management of a patient stung by a honey bee? A) Soak the affected area in warm water. B) Pull the stinger out using tweezers. C) Remove jewelry from any affected limbs. D) Elevate the affected site above the level of the heart to reduce swelling.

Q: Which of the following spiders can cause a characteristic wound with a bite that is often painless? A) Brown recluse spider B) Sheet web spider C) Argiope spider D) Black widow spider

Q: To rescue someone who has fallen through the ice, which of the following is the safest device to use? A) Jet-ski B) Flat-bottomed aluminum boat C) Ladder D) Ring buoy

Q: You are enjoying some time at the beach on your day off when you hear a swimmer crying for help. As you spot the swimmer about 30 feet from shore, she cries out again but appears to be getting weaker. Although there is no lifeguard on duty, there is a rowboat and a ring buoy available. Assuming you do NOT know how to swim or consider yourself a poor swimmer, which of the following should you do first? A) Row the boat out to the swimmer. B) Use the buoy to float out to the swimmer. C) Find someone who can swim to try to swim out and save the swimmer. D) Call for help and try to throw the buoy to the swimmer.

Q: You respond to a boat dock for a diving injury. You find a 22-year-old female patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The patient's friends state they were diving when she unexpectedly came out of the water complaining of chest pains and then collapsed. The nearest hospital is 25 minutes away and the nearest specialty resource center with a hyperbaric chamber is 30 minutes away. What is the best decision when determining transport? A) Transport the patient by ground to the specialty center. B) Transport the patient by air medical to the specialty center. C) Transport the patient to the nearest facility. D) Transport the patient by air medical to the nearest facility.

Q: You arrive on the scene to find a scuba diver on board a boat slumped over in the captain's chair with frothy blood in his mouth. The captain states that the diver was down no more than 15 feet when he ascended rapidly and called for help. Which of the following is most likely? A) Decompression sickness B) The bends C) Air embolism D) Caisson's disease

Q: Which of the following increases a scuba diver's risk of decompression sickness? A) Taking cold or sinus medications before a dive B) Flying within several hours after a dive C) Diving on a full stomach D) Breathing 100% oxygen before a dive

Q: Which of the following is caused by trapped nitrogen gas in the tissues due to a rapid ascent from a scuba dive? A) "Squeeze" injuries of the ear and sinuses B) Pulmonary embolism C) Decompression sickness D) Nitrogen narcosis

Q: Which of the following occurs when gases leave a damaged lung in a diving accident and enter the bloodstream? A) Arterial thrombosis B) Arterial blood gases C) Hyperbaric arterial injury D) Arterial gas embolism

Q: You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient is breathing 28 times a minute. The patient's friends state they were diving when he unexpectedly came out of the water complaining of chest pains and then collapsed. What is your first action? A) Insert an oropharyngeal airway. B) Place the patient on high-concentration oxygen by nonrebreather mask. C) Place the patient on high-concentration oxygen by bag-valve mask. D) Suction the airway.

Q: You have responded to a local pool for a drowning patient. Lifeguards have pulled the patient out of the pool prior to your arrival. You find the 16-year-old patient unresponsive with agonal respirations and a weak carotid pulse. What is your first action? A) Apply high-concentration oxygen by nonrebreather mask. B) Apply high-concentration oxygen by bag-valve mask. C) Insert a Combitube. D) Insert an oropharyngeal airway.

Q: You respond to a boat dock for a diving injury. You find a 24-year-old male patient unresponsive with frothy blood in the mouth and lung sounds absent on the right side. The patient's friends state they were diving when he came out of the water complaining of chest pains and then collapsed. What condition do you suspect? A) Myocardial infarction B) Decompression sickness C) Air embolism D) Near drowning

Q: You have responded to a local pool for a drowning patient. Lifeguards have pulled the patient out of the pool prior to your arrival. You find a 22-year-old male patient unresponsive with agonal respirations and a weak carotid pulse. Bystanders state the patient was not using the diving board and was found in the shallow end. Why are cervical spine precautions necessary? A) The patient may have suffered a spinal injury by jumping in shallow water. B) The patient may have suffered a cervical spine injury when pulled out of the water. C) The patient may have been using the diving board after all and injured his cervical spine. D) The patient may have hit his head on the side wall while swimming laps.

Q: Which of the following is often associated with water-related emergencies? A) Hypothermia B) Cardiac arrest C) Alcohol use D) All of the above

Q: Regarding drowning in adults, which of the following statements is true? A) Colder water improves survival chances in saltwater drowning but not in freshwater drowning. B) Water temperature makes no difference in the chances of survival in either saltwater or freshwater drowning. C) The colder the water, the better the chances of survival in either saltwater or freshwater drowning. D) The warmer the water, the better the chances of survival in saltwater drowning.

Q: When submerged in water, biological death may be delayed if the water temperature is below ________F. A) 70 B) 98.6 C) 50 D) 32

Q: You respond to a construction site on a very hot summer day for a person "not acting right." You find a 38-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is cool to the touch and dry but his shirt is wet with visible salt rings. Which is the best treatment for the patient? A) Apply high-concentration oxygen and rapidly transport to the nearest medical facility. B) Have the patient sip water slowly to replace what he has lost. C) Cool the patient with tepid water. D) Have the patient drink at least 1 liter of water to replace what he has lost.

Q: You respond to a construction site on a very hot summer day for a person "not acting right." You find a 44-year-old male patient seated in a work vehicle with the air conditioner on maximum. Coworkers state the patient was working for the last 2 hours pouring concrete when he started "speaking gibberish" and nearly collapsed. The patient is responsive to verbal stimuli. Your initial vital signs are blood pressure 90/60, pulse 136, and respiratory rate 24. The patient's skin is cool to the touch and dry, but his shirt is wet with visible salt rings. You suspect: A) heat cramps. B) hypernatremia. C) heat exhaustion. D) myocardial infarction.

Q: Your patient is a 44-year-old female with a history of alcoholism. She has been walking around at an outdoor fair on a hot, sunny day. She is disoriented to time; has hot, dry skin; and appears to be generally weak. Which of the following is the appropriate sequence of treatment for this patient? A) Have the patient drink an electrolyte solution or sports drink and apply cold packs to her neck, armpits, and groin. B) Get as much ice as possible from the food vendors at the fair, place the patient in a large container of ice, and apply oxygen by nonrebreather mask. C) Give oxygen by nonrebreather mask, have the patient sip a sports drink or electrolyte solution, remove heavy clothing, and place cold packs on her neck, armpits, and groin. D) Give oxygen by nonrebreather mask, remove heavy clothing, and place cold packs on her neck, armpits, and groin.

Q: Heat stroke is caused by which of the following mechanisms? A) Blockage of blood flow to the brain B) Extreme dilation of all the blood vessels C) Failure of temperature regulation mechanisms D) Heat-induced swelling of brain tissue

Q: You respond to a professional volleyball tournament for a potential heatstroke. Upon arrival you find a 28-year-old male patient seated inside the air-conditioned first aid trailer. He is alert and in obvious distress. He is complaining of severe cramping of his arms and legs. His vital signs are stable. What is the most likely cause of the cramping? A) Heat exhaustion B) Drinking too many sports drinks C) Sweating too much D) Cooling off too quickly

Q: Heat cramps occur due to loss of which of the following substances? A) Water B) Salt C) Magnesium D) Water and potassium

Q: Which patient is the highest priority? A) Patient with a Glasgow Coma Scale of 15 B) Patient with a Revised Trauma Score of 12 C) Patient with a penetrating chest injury D) Patient with a broken femur

Q: What are the three elements of the Revised Trauma Score? A) GCS, pulse rate, and respiratory rate B) GCS, systolic blood pressure, and pulse rate C) GCS, systolic blood pressure, and respiratory rate D) Level of consciousness, systolic blood pressure, and pulse rate

Q: According to CDC guidelines, a systolic blood pressure (BP) of less than ________ indicates a patient should be transported to a trauma center. A) 90 B) 100 C) 110 D) 80

Q: You are transporting a stable patient who was involved in a minor fall from a ladder at a height of about 10 feet to a local community hospital. You assumed full spinal precautions not only because the patient has midline back pain in the sacrum, but also because he was knocked unconscious. While transporting, the patient begins to become increasingly confused, develop an irregular respiratory rate, and experience a drop in heart rate with an increase in blood pressure. You just called in a radio report and are about 7 minutes from the hospital. A trauma center is about 10 minutes away. Which of the following is the BEST transport decision? A) Call medical control for advice from the trauma center. B) Divert to the trauma center because the patient is becoming symptomatic. C) Continue transporting to the local hospital because you've already given report and they accepted the patient. D) Continue transporting to the local hospital since it's the closest facility.

Q: You encounter an accident on a busy intercity street while on duty. Calling into dispatch, you make note that the occupants of both vehicles are outside, and you request additional units to proceed non-emergently. You approach an elderly male who is rubbing his back and left shoulder. During secondary assessment of past medical history, you make note of several important details: the patient is on high blood pressure medications, and has had a heart attack in the past. He is complaining of midline thoracic pain on palpation of his spine and left shoulder pain, which may have been from the seat belt, but is refusing care and transport. The patient did not lose consciousness. Based on this information, which transport decision would be most appropriate for this patient? A) Take the patient to a trauma center. B) Allow the patient to sign a refusal. C) Call for ALS intercept. D) Take the patient to a local community hospital.

Q: You respond to a 32-year-old male who fell 20 feet off a ladder. He is responsive to painful stimuli. He has snoring respirations at 20 a minute with decent chest rise and fall. He has a broken femur, a broken wrist, and a lacerated radial artery that is bleeding profusely. Which of these injuries is the highest priority? A) Arterial bleed B) Snoring respirations C) Broken wrist D) Femur fracture

Q: Which of the following is the most significant mechanism of injury for a driver in a vehicle accident? A) Spidering of the windshield B) Encroachment greater than 12 inches of the driver's compartment C) Death of a passenger in the same vehicle D) Rear-end collision

Q: Which of the following choices is NOT a justifiable reason for delaying transport of a critical trauma patient? A) Suctioning the airway B) Awaiting arrival of the patient's parents on-scene C) Ventilating a patient in respiratory distress D) Immobilizing the patient to a long spine board

Q: You are dispatched to a motorcycle crash with one patient involved. What is the most important intervention to perform first? A) Begin chest compressions. B) Manually stabilize the cervical spine. C) Suction the vomit and secretions from the airway. D) Stabilize the pelvis to a long spine board.

Q: Which of the following trauma triage criteria would justify transportation to a trauma center based on mechanism of injury alone? A) Vehicle rollover B) Vehicle crash-generated telemetry data C) Intrusion into the occupant area greater than 8 inches D) Auto versus pedestrian

Q: What criteria based on the CDC guidelines allows a discretionary approach to trauma triage? For example, a patient not meeting ordinary trauma triage criteria may be transported to a trauma center based on what consideration? A) Review of morbidity and mortality B) CDC "No-protocol Protocol" C) "Golden Hour" criteria D) EMS provider judgment

Q: A respiratory rate of less than ________ in infants is a significant finding and indicates a critical patient, who should be immediately transported to a trauma center if secondary to trauma. A) 20 B) 25 C) 18 D) 30

Q: You are dispatched to a motor vehicle crash on a rural mountain highway. You have a patient who was unconscious on arrival, had a seizure, and is currently awake but combative. You suspect he may have a head injury. What is considered the BEST approach regarding transport of this patient? A) Dispatch and await the medical helicopter, which is 20 minutes away. B) Transport to a local community hospital approximately 15 minutes away via ground. C) Begin transport to the trauma center on the ground, which is 1.5 hours' driving time. D) Dispatch the medical helicopter to meet your unit at the community hospital.

Q: What is the BEST option an EMT has when encountering poor BVM compliance when attempting to ventilate a patient? A) Begin chest compressions. B) Place the patient on supplemental oxygen. C) Address ventilation en route to the hospital or ALS intercept. D) Involve two people in the procedure.

Q: You are getting ready to transport an unresponsive 25-year-old female patient. She was hit by a vehicle while crossing the street. She is 26 weeks pregnant. You are 10 minutes away from the nearest facility, 15 minutes away from a Level I Trauma Center, and 15 minutes away from a hospital that specializes in high-risk obstetrics. You should transport the patient to which hospital? A) The nearest facility: she is unresponsive and unstable B) The trauma center: the fetus will need specialized neonatology surgeons C) The trauma center: the patient will need specialized trauma surgeons D) The high-risk obstetric hospital: the fetus will need specialized neonatology surgeons

Q: Which patient is the most unstable? A) Unresponsive patient with hypotension B) Patient who only responds to verbal stimuli C) Unresponsive patient with tachycardia D) Patient responsive to painful stimuli only

Q: What type of trauma triage criteria regarding transport would a finger amputation receive? A) Any hospital, as long as on-line medical direction approves the facility's capabilities B) Any hospital with surgical facilities C) Trauma center D) Patient's choice of destination

Q: Which one of the following patients would justify the need to directly transport to a trauma center based on special patient considerations? A) An end-stage renal disease (ERSD) patient who tripped and fell and is complaining of shoulder pain on the same side as his shunt B) An unlicensed teenage driver who has a pulse rate of 120 after a MVC and a 4 minute EMS response C) A pregnant female in the third trimester who is spotting (showing small amounts of vaginal bleeding) following a low mechanism of injury MVC D) An elderly patient on anticoagulants who slipped out of her wheelchair and is complaining of pelvic pain

Q: Which trauma patient is the most critical? A) Patient with decerebrate posturing B) Patient with a Glasgow Coma Scale of 7 C) Patient with decorticate posturing D) Patient who withdraws to painful stimuli

Q: A respiratory rate of less than ________ and greater than ________ in cases of trauma are criteria for immediate transportation to a trauma center according to the CDC physiologic guidelines. A) 8; 32 B) 10; 29 C) 12; 20 D) 5; 45

Q: You are on the scene of a 50-year-old male who lacerated his arm on a sheet of plate glass. He is pale, diaphoretic, and mumbling incoherently. You have controlled an arterial bleed with direct pressure. His blood pressure is 70/40, pulse 120, and respiratory rate of 28. Which of the following signs is the most concerning? A) Tachycardia B) Altered mental status C) Respiratory rate D) Blood pressure

Q: What is the height from which an adult fall would meet trauma triage criteria set forth by the CDC? A) 10 feet B) 25 feet C) 20 feet D) 15 feet

Q: What is the Glasgow Coma Score (GCS) measurement of altered mental status, which according to CDC guidelines necessitates transport to a trauma center? A) 12 B) 13 C) 8 D) 14