EMT Ventilation Scenario

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Questions and Answers

Which of the following assessment findings would MOST likely support a diagnosis of thoracic outlet syndrome?

ST-segment depression on the 12-lead ECG tracing

Disappearance of radial pulses during expiration

Bruits to both carotid arteries during auscultation

Difference in blood pressure between the two arms (correct)

A patient with crushing chest pain has 3 mm of ST elevation in leads V1, through V4. What should you suspect?

Left circumflex occlusion

Left anterior descending artery occlusion (correct)

Right ventricular infarction

Right coronary artery occlusion

What is a classic sign of atrial flutter?

The presence of sawtooth F waves (correct)

An irregular but consistent R-R interval

A ventricular rate less than 100 beats/min

A constant 2:1 conduction ratio

A decreased cardiac output secondary to a heart rate greater than 150 beats/min is caused by:

Decreases in stroke volume and ventricular filling Signup and view all the answers

A delta wave is identified on a cardiac rhythm strip as a(n):

Slurring of the upstroke of the first part of the QRS complex Signup and view all the answers

A major complication associated with atrial fibrillation is:

Clot formation in the fibrillating atria Signup and view all the answers

A pathologic Q wave is typically:

Deeper than one quarter of the height of the R wave and indicates injury Signup and view all the answers

What is the most likely cause of right ventricular infarction?

Right coronary artery occlusion Signup and view all the answers

What type of episode is the advanced EMT student experiencing during IV skills practice?

Syncopal episode Signup and view all the answers

What is the primary concern for the 74-year-old male resident who is unable to move his head?

Medication interaction Signup and view all the answers

What is the most reliable indicator of significant energy dissipation by braking before a motor vehicle collision?

The presence of tire skid marks at the scene Signup and view all the answers

What characteristic of an entry wound indicates that the weapon was fired at close range?

Tattoo marks from powder burns Signup and view all the answers

What is the primary reason for the paramedic's acute anxiety upon arriving at the scene of a motor-vehicle-versus-pedestrian incident?

Previous traumatic experience Signup and view all the answers

What is the correct treatment for the 74-year-old male resident who is experiencing symptoms related to Seroquel?

Administer 25 to 50 mg of diphenhydramine Signup and view all the answers

What is NOT a factor when considering transport of a trauma patient via helicopter?

Patient's insurance coverage Signup and view all the answers

What is the primary concern for the elderly woman who is afraid of losing her independence?

Fear of being institutionalized Signup and view all the answers

What is the primary focus when caring for a patient who experienced blunt abdominal trauma?

Basic airway and circulation support at the scene Signup and view all the answers

What is the correct initial management of a patient with a grossly deformed elbow?

Splint the elbow in the position found and reassess distal circulation Signup and view all the answers

Which of the following is NOT a common sign or symptom of an acute pulmonary embolism?

Pulmonary edema Signup and view all the answers

What should you suspect when discovering a rapidly expanding hematoma on the medial aspect of a patient's thigh?

Arterial injury Signup and view all the answers

What is the primary goal when caring for a patient with blunt abdominal trauma?

Maximizing the patient's chances of survival Signup and view all the answers

What is the correct management of a patient with a femur fracture?

Splint the injury in the position found and reassess distal circulation Signup and view all the answers

What is a common sign of an acute pulmonary embolism?

Tachycardia and tachypnea Signup and view all the answers

What is the correct initial management of a patient with blunt abdominal trauma?

Basic airway and circulation support at the scene Signup and view all the answers

A patient's respiratory rate and depth have decreased, what should you do?

Begin assisting his ventilations with a bag-mask and 100% oxygen Signup and view all the answers

What should you suspect if a patient on a CPAP unit starts to deteriorate?

The patient has developed a pneumothorax Signup and view all the answers

What is the classic presentation of chronic bronchitis?

Excessive mucus production and a chronic or recurrent productive cough Signup and view all the answers

How many PVCs in a row are required to be considered a 'run' of ventricular tachycardia?

Three Signup and view all the answers

A patient complains of severe pain between his shoulder blades, which he describes as 'ripping' in nature. What should you suspect?

An aortic dissection Signup and view all the answers

A patient is on high-flow oxygen via nonrebreathing mask and has an IV of normal saline in place. What should you reassess?

The patient's respiratory rate and depth Signup and view all the answers

What should you do if a patient's CPAP unit is not functioning properly?

Remove the CPAP unit and assist his ventilations with a bag-mask device Signup and view all the answers

What is the primary concern for a patient with a history of emphysema?

Respiratory failure Signup and view all the answers

During CPR, how often should one breath be delivered?

every 3 to 5 seconds Signup and view all the answers

What is the maximum time a person should perform chest compressions at a time?

5 minutes Signup and view all the answers

What treatment is NOT recommended for a 68-year-old man with an organized cardiac rhythm at a rate of 80 beats per minute and an absent carotid pulse?

cardiac pacing Signup and view all the answers

What should be the next action for a 6-year-old in ventricular fibrillation after an initial defibrillation and 2 minutes of CPR?

defibrillate with 70 joules Signup and view all the answers

What should be done after a shock is delivered to a patient in pulseless ventricular tachycardia?

administer 150 mg of amiodarone Signup and view all the answers

What should be done after a patient experiences a return of spontaneous circulation?

hypothermia treatment Signup and view all the answers

What should you do first if you witness an elderly man grab his chest and collapse to the ground?

tell your partner to call 9-1-1 as you proceed to assess the man Signup and view all the answers

What is the goal of chest compressions during CPR?

to mimic the heart's pumping action Signup and view all the answers

Study Notes

Respiratory Emergencies

In a patient with a long history of emphysema, if the respiratory rate and depth have decreased, begin assisting ventilations with a bag-mask and 100% oxygen.
If a patient's respiratory rate and depth have decreased, consider inserting a nasal airway, applying a CPAP unit, and notifying medical control.

Cardiac Emergencies

A "run" of ventricular tachycardia occurs if at least three PVCs occur in a row.
A classic sign of atrial flutter is the presence of sawtooth F waves on a cardiac rhythm strip.
A decreased cardiac output secondary to a heart rate greater than 150 beats/min is caused by decreases in stroke volume and ventricular filling.
A delta wave is identified on a cardiac rhythm strip as a slurring of the upstroke of the first part of the QRS complex.
A major complication associated with atrial fibrillation is clot formation in the fibrillating atria.

Medical Emergencies

A patient with a severe pain between the shoulder blades, described as "ripping" in nature, and a history of noncompliance with antihypertensive medication, may have a difference in blood pressure between the two arms.
A patient with a head cocked to the side and unable to move it, and a recent history of being placed on Seroquel, may require administration of 25 to 50 mg of diphenhydramine.

Trauma Emergencies

A pathologic Q wave generally indicates that an acute myocardial infarction has occurred within the past hour.
The most reliable indicator that significant energy was dissipated by braking before a motor vehicle collision is the presence of tire skid marks at the scene.
A characteristic of an entry wound that indicates the weapon was fired at close range is the presence of tattoo marks from powder burns.
To maximize a patient's chances of survival after blunt abdominal trauma, provide basic airway and circulation support at the scene, prompt transport to a trauma center, and IV fluid boluses as needed en route.
A patient with a femur fracture and a rapidly expanding hematoma on the medial aspect of the thigh may have an arterial injury.

Pediatric Emergencies

A 6-year-old child who remains in ventricular fibrillation after an initial defibrillation and 2 minutes of CPR requires defibrillation with 70 joules.

Resuscitation

During cardiac arrest, compressions should be hard and fast, with full chest recoil between compressions.
A patient who remains in pulseless ventricular tachycardia despite two shocks, a dose of epinephrine, high-quality CPR, and 300 mg of amiodarone requires administration of 150 mg of amiodarone.
After approximately 6 minutes of attempted resuscitation, a patient who experiences a return of spontaneous circulation requires hypothermia treatment.
If you witness a person collapse, proceed to assess the person and tell your partner to call 9-1-1 as you begin two-rescuer CPR if needed.

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Description

An EMT scenario involving a patient with respiratory issues, requiring ventilation assistance. Test your knowledge of emergency medical procedures.