You are assigned to a paramedic unit and receive a call to an elderly housing unit for the report of a 76-year-old man who fell. You find the man on the floor of his room, in pain, and you immediately notice that his right foot and knee are pointing outward. You do an assessment and obtain vital signs before calling medical control for an order to give pain medication. Which of the following terms should you use when describing the position of the leg to medical control?
You arrive at the scene of a bar fight. Your patient has a penetrating stab wound on his left anterior chest about 2 inches above the nipple line. Which of the following conditions is your greatest concern?
developing tension pneumothorax
Maintenance of a relatively stable internal physiologic environment in which the cells live is called:
What is the movement of water out of plasma across the capillary membrane into interstitial space due to hydrostatic pressure called?
Small, rod-like organelles that function as the metabolic center of the cell are called
You arrive on the scene of a stabbing. A 23-year-old man has a knife wound approximately 10 cm inferior to armpit. Which of the following anatomical terms best describes the location of the wound?
Which of the following types of epithelium consists of single layer of cells of varying heights?
Amino acids are formed by joining an "R" group to a central carbon atom already bonded to a H, an amino group, and a(n):
carboxyllic acid group
A patient is having trouble breathing and showing signs of a heart attack. The patient is placed on a stretcher, seated, with the back of the stretcher about halfway up. This position is called _______ position.
Your ambulance is dispatched to a 6-month-old patient who is reported to have been sick for two days with diarrhea and vomiting. After performing the assessment you suspect dehydration. One of the signs you should check is the head, where you would expect to find what landmark sunken?
A fracture to the humerus is best described as having what anatomical location in relationship to the elbow?
A 55-year-old man has signs and symptoms consistent with an infection after a colonectomy to treat his colon cancer. Which of the following is the most likely?
Your patient was the restrained driver in a high energy MVC where another vehicle struck his vehicle at the driver's door. He is showing signs of hypovolemic shock. However, there is no obvious evidence of trauma other than a faint large bruise over his LUQ. Which of the following internal organs would you suspect to be injured?
spleen, right kidney, liver, esophagus
You respond to a call for a 3-year-old in the care of a babysitter, who reports that the child fell from the top of a sliding board. Upon arrival you find the child lying on the ground in a supine position and not moving. You immediately start to hold in-line stabilization and check the ABCs. As you position your hands, you notice the child's head is tucked forward with the chin touching the chest. Which term best describes this position?
When placing a patient on a long board for spinal immobilization, what body surface of the patient is in contact with the board?
A motor vehicle accident has resulted in a patient with a traumatic closed head injury. Upon arrival at the hospital you are informed that the patient has an internal hemorrhage. The bleeding is most likely in which cavity?
Which of the following is NOT one of the stages of mitosis?
Metaphase, Nucleophase, Anaphase, Telophase
Which of the following patients do you think would be the best candidate for administration of IV sodium bicarbonate?
A. A hyperventillating 17 year old with ETCO2 of 17 torr
B. A full arrest patient with a pH of 7.47
C. A hypoventillating CHF patient with ETCO2 of 49 mmHg
D. A trauma arrest patient with a pH of 7.10
A trauma arrest patient with a pH of 7.10
The movement of a substance accross the cell membrane against a concentration gradient is called:
A man is lying on his back with his legs elevated approximately 12 inches and his head down. What is this position called?
A solution that has equal osmotic pressure to cells and body fluid, such as normal saline, is said to be:
Your patient has a penetrating injury 2" superior and 4" laterally to the left of his umbilicus. The associated exit wound is in the sacral midsagittal region. Which of the following MUST be perforated?
B. left kidney
D. descending abdominal aorta
Which of the following is NOT a type of muscle?
You contact medical control and receive an order for 0.45% sodium chloride in water (1/2 NS). Knowing that 0.9% sodium chloride is isotonic to whole blood, what type of solution is 1/2 NS?
The major source of energy for all chemical reactions of the body is/are:
adenosine triphosphate (ATP).
While doing a physical assessment you have rebound tenderness in the quadrant where the gall bladder is located. Which of the following best describes that anatomical location of the abdomen?
Right upper quadrant (RUQ)
What is the movement of solutes from an area of higher concentration to one of lower
You have treated a motorcyclist for a right tibia/fibula fracture. The deformity is below the knee. When making the radio report to the hospital, which of the following terms most correctly describes the location of the injury?
A. Proximal to the knee
B. Inferior to the knee
C. Distal to the knee
D. Superior to the knee
Inferior to the knee
Organelles that contain RNA and protein and that interact with RNA from other parts of the cells to join amino acids together to form proteins are called:
In dealing with an epileptic patient, which emergency procedure should be initiated first?
Protect the patient from injuries
The treatment of the CVA/TIA victim includes airway management, oxygen administration, ventilatory assistance, and -
a bolus of NS if the patient is hypotensive since dehydration can
sometimes mimick the signs and symptoms of CVA
Transient ischemic attacks (TIAs) are defined as episodes of cerebral dysfunction with signs and
symptoms similar to that of CVAs, lasting -
anywhere from 2 to 3 minutes to several hours, but always less than
Generalized, full-body tonic-clonic activity, occasionally resulting in tongue biting, is indicative of
grand mal seizures
Status epilepticus is defined as
two or more seizures without an intervening period of consciousness
Decorticate or decerebrate posturing indicates the presence of:
A significant brain injury that is life-threatening
When provided with a pain stimulus, your patient extends and abducts both arms. This response
When provided with a pain stimulus, your patient flexes and/or retracts the stimulated area to
avoid or escape thestimulus. This response characterizes:
A withdrawal response to pain
Which of the following are the two most important prehospital considerations for reducing
secondary brain injury?
Ventilation and maintaining adequate blood pressure
Which of the following is a disease that affects the dopamine-producing basal ganglia and is
characterized by tremors, muscle rigidity, and bradydinesia?
Which of the following diseases involves inflammation followed by demyelination of the brain and
spinal cord nerve fibers?
Your patient is a 48-year-old female who is alert and oriented after a possible seizure. Her friends state they witnessed her slump to the floor and "shake" for about 15 seconds. She awoke in less than 1 minute and was "a bit groggy" for a few minutes. She does not believe she had a seizure, but thinks she may have fainted. Which of the following questions is LEAST important when differentiating seizure and syncope?
A. "Did you injure yourself during the event?"
B. "What happened just before the event?"
C. "What kind of medications do you take?"
D. "Do you have a history of seizures?"
"Did you injure yourself during the event?"
Which of the following is an example of a demyelination disorder?
A. Cerebal palsey
C. Heavy metal poisoning
D. Down Syndrome
Heavy metal poisoning
Which of the following is caused by incomplete development of the brain, spinal cord, or meninges Which of the following is caused by incompete development of the brain, spinal cord, or neninges
What sign might be displayed by a syncopal patient, which bystanders can mistake for seizure
Which of the following is an indication of rising ICP?
A. Cushing's Triad
B. Beck's Triad
C. Saulk's Triad
D. Kussmaul's Triad
The greatest danger in the administration of Narcan to an addict who has overdosed on heroin is
Your unit is called to assist the police with a 29 year old male patient. The patient is restrained by officers before your arrival. Apparently, the patient was found naked, running down the center of a busy city street shouting that aliens were chasing him. His vital signs are BP 188/72, P 132, R 28 with dilated pupils. Which drug do you think the patient has taken?
Your patient is a 54 year old female that has just been removed from a house fire where she was entrapped for approximately 15 minutes. She has no visible trauma or burns. She is alert, but
not oriented. Her vital signs are BP 132/78, P 128, R 32 with bilateral crackles and an SpO2 of 98% on room air. As you finish your assessment, she becomes unresponsive and begins to
actively seize. You suspect
carbon monoxide poisoning.
Your comatose patient's pupils are 2 mm wide, equal, round, and are reactive to light. This
Which of the following interventions would be MOST appropriate for a patient that has overdosed on haloperidol and is experiencing dystonic reactions?
A. sodium bicarbonate 1-1.5mEq/kg
B. 5mg diazepam IM
C. Calcium gluconate 2g slow IVP
D. diphenhydramine 50mg IV
sodium bicarbonate 1-1.5mEq/kg
Charcoal is effective in treating specific overdoses because it....
binds with the drug and stops its absorption
Your patient is cyanotic and complaining of shortness of breath. He has just returned from the dentist where he was administered benzocaine. He is also complaining of headache and dizziness. His vital signs are: BP-128/82; P-122; RR-28 with an SpO2 of 91%. His breath sounds are clear bilaterally and he has no significant medical history. Which of the following medications would you expect to help this patient the most?
C. sodium bicarbonate
D. methylene blue
Your 44 year old patient has intentionally overdosed on labetalol. Which of the following drugs would you expect to give this patient?
B. calcium gluconate
C. both A and B
D. neither A nor B
both A and B
Your patient has overdosed on diltiazem. You might expect orders to administer:
A. calcium gluconate
B. sodium nitrite
D. Both A and C
Both A and C
Your eleven year old patient has overdosed on his grandfather's Prazosin. Prazosin is a selective Alpha 1 antagonist. Which of the following signs might you expect?
Your 3 year old patient has ingested several of his mother's daily vitamins. Which of the following vitamin components is your greatest concern?
Your patient has inadvertantly overdosed on his Nortriptyline. You should expect to recieve orders that include:
Your patient is a 28 year old male who is complaining of chest pain and anxiety. He admits to "smoking crack". Which of the following interventions should you anticipate?
administration of diazepam
Your six year old patient has mistaken anti-freeze for Kool Aide. She has ingested over two cups of the toxin. What physiological changes would you expect?
low serum pH levels
Ingestion of methanol can result in _____________.
C. low serum pH
D. Both A and C
Both A and C
Which of the following statements about N. meningitidis is TRUE?
It is the bacteria that most often causes serous cases of meningitis.
Which of the following statements about mumps is TRUE?
A. Mumps are not highly communicable.
B. Mumps are of no concern to the adult patient.
C. There is no vaccine for the mumps virus.
D. Mumps are characterized by enlargement of the salivary glands.
Mumps are characterized by enlargement of the salivary glands.
Which of the following statements about rubella and the rubella virus is FALSE?
A. Mothers infected with rubella during the first trimesters are at risk for
abnormal fetal development.
B. The virus is spread via contact with infected blood and body fluids.
C. Immunization via the MMR vaccination is 98-99 percent effective.
D. EMS providers should receive an MMR vaccination.
The virus is spread via contact with infected blood and body fluids.
Which of the following statements about measles and the measles virus is FALSE?
A. Measles is transmitted by inhalation of infected droplets.
B. Signs of measles infection include high fever and a maculopapular
C. Measles is highly communicable.
D. Immunization is ineffective until age 15.
Immunization is ineffective until age 15.
Which of the following statements about herpes simplex type 2 (HSV-2) is FALSE?
A. In addition to painful lesions to the infected area, fever and enlarged
lymph nodes can be present during the initial presentation of the
B. Treatment with Acyclovir can eradicate the virus.
C. There is a low risk of disease transmission via casual contact.
D. HSV-2 is responsible for 70-90 percent of all genital herpes cases.
Treatment with Acyclovir can eradicate the virus.
Which of the following is NOT a common pediatric viral disease?
Your patient is a 21-year-old male who is alert and oriented, complaining of a rash that started about 36 hours ago, first appearing on his trunk. The rash has now spread to his face and extremities. You notice multiple small, fluid-filled vesicles on the patient's body. The patient is concerned that he will miss work as a second grade student teacher. He has no medical history, including no childhood diseases. The patient is most likely suffering from:
Which of the following statements about influenza is true?
A. Adults become contagious the day before symptoms occur and
remain contagious for a week
B. Each year the CDC creates a vaccine for one strain of influenza A and
one strain of influenza B
C. Once a person has been infected with influenza, he/she develops life-
long immunity to all strains of influenza
D. Rimantadine shortens the duration of both Influenza A and Influenza B
Adults become contagious the day before symptoms occur and
remain contagious for a week
Which of the following statements is true regarding gonorrhea?
A. Gonorrhea may lead to PID.
B. Gonorrhea can not be treated with antibiotics
C. Women infected with gonorrhea are typically asymptomatic.
D. Both A and C
Both A and C
Your patient has a painful erythema migrans on his leg. He tells you that his symptoms started about three weeks after returning home from a backpacking trip in Montana. He is complaining of joint pain and Bell's palsey. You suspect:
During the examination of an 18-year-old female patient complaining of abdominal pain, the patient denies nausea, vomiting or diarrhea. She also denies the possibility of pregnancy. These denials are known as:
The cause of acute abdominal pain is most accurately assessed in the pre-hospital setting by..
While examining a patient who is complaining of abdominal pain, the:
Quadrant with pain should be palpated last
Your patient is a 45-year-old type I diabetic complaining of a 5-day history of abdominal pain, nausea/vomiting, and increased urination and thirst. His skin and mucus membranes are warm and dry. HR =112 bpm and regular, BP = 94/60, RR = 12 and regular. Your treatment for this patient would most likely include:
IV of NS 1-2 L.
Your patient is a 22-year-old female in mild distress who is complaining of left lower quadrant abdominal pain and nausea. Which of the following questions would be LEAST helpful when determining the etiology of her abdominal pain?
A. "Have you ever had a sexually transmitted disease?"
B. "When did your last menstrual period start?"
C. "Are you having any vomiting or diarrhea?"
D. "When did the pain start?"
Have you ever had a sexually transmitted disease?
Your patient is a 12-year-old male who is conscious and alert, complaining of diffuse abdominal pain. He states that the pain began about 3 hours after eating supper. He has had severe diarrhea and some vomiting. You might elect to administer any of the following EXCEPT:
D. IV of NS.
Your patient is a 19-year-old male complaining of a 2-day history of abdominal pain described as
diffuse and colicky, located around his umbilical area. He also states a loss of appetite and a low- grade fever over the same period. Palpation of his abdomen reveals tenderness and guarding to
the periumbilical area. Of the following, which is the most likely cause of his clinical condition?
B. Bowel obstruction
C. Peptic ulcer disease
A 52-year-old male is in moderate distress, complaining of nausea and vomiting. He describes a 3-day history of upper left quadrant abdominal pain described as sharp and radiating to his back. You note a slightly distended abdomen. He called EMS today when he developed nausea and vomiting. He denies any change of bowel habits and states he has a history of alcoholism. Of the following, which is the most likely cause of his clinical condition?
Which of the following in NOT a life-threatening GI condition associated with hemorrhage?
A. ruptured ectopic pregnancy
B. ruptured spleen
C. GI bleed
D. acute pancreatitis
Your patient is a 67 year old male who complains of upper abdomninal pain, nausea, and weakness. In addition to oxygen and IV access, which of the following is MOST important in the
pre-hospital setting for this patient?
A. ausculation of bowel sounds
B. 12-Lead EKG
C. physical exam of the abdomen
D. administration of nitrous oxide
Mesenteric ischemia refers to a compromise in the vascular supply to which of the following organs?
Which of the following is an inflammatory bowel disease?
A. ulcerative colitis
B. Addison's disease
C. Crohn's disease
D. Both A and C
Both A and C
Your 22 year old patient is complaining of abdominal cramping, fever, nausea, and
hematochezia. Of the following, you would suspect:
E. coli infection
When the sacs or pouches protruding out from the bowel become inflamed, the condition is known as:
Alcohol abuse often causes elevated venous pressure from a back-up of blood from the liver called portal hypertension. What potential cause of upper GI bleeding is caused by portal
The end stage of liver disease marked by the permanent destruction of hepatocytes is called:
An increased number of mucous-secreting cells in the respiratory epithelium, producing large amounts of sputum, is characteristic of -
You place your CHF patient with severe pulmonary edema on CPAP en route to the hospital. Upon arrival, the hospital staff abruptly removes the CPAP to obtain a "room air" saturation. You would
expect the patient to:
become acutely worse
You are dispatched to a dialysis clinic to treat a patient complaining of difficulty breathing. Upon arrival, you find a 71 year old male with bilateral wheezing. A brief history reveals that the patient has a history of asthma and has just completed 15 minutes of his dialysis treatment. The most appropriate IV therapy for this patient would be:
0.45 percent saline with a micro drip set
You have successfully resuscitated your patient from cardiac arrest of cardiac etiology. He is intubated and you are ventillating him with a BVM and supplemental oxygen at a rate of 1 breath
every 6 seconds. You note that his ETCO2 has risen to 47 torr while keeping a normal pattern. Which of the following is the most appropriate action?
A. extubate immediately and resume ventillations with the BVM only
B. hyperventillate at 1 breath per second
C. increase ventillations to 1 every 4-5 seconds
D. decrease ventillations to 1 every 7 seconds
increase ventillations to 1 every 4-5 seconds
The pathophisiology in which the pressure inside of the capillaries at the alveoli-capillary membrane forces fluid into the alveoli causing respiratory distress is known as:
congestive heart failure (CHF)
During transport of your intubated patient, you note a sudden decrease in the patient's capnography reading from 38 to 16 mmHg. You should:
reassess the ABC's
This drug slows conduction time through the AV node, can intereupt the reentry pathways through the AV and SA nodes, and can restore NSR in patients with PSVT, including PSVT from WPW
Adenosine mechanism of action
If the patient is hemodynamically unstable, administration of this drug should not delay appropriate cardioversion
Class 3 antiarrythmic agent which inhibits adrenergic stimulation (alpha- and beta- blocking), affects Na+, K+, and Ca+ channels, prolongs the action potential and vascular smooth muscle, decreases peripheral vascular resistance, increases coronary blood flow, and blocks effects of sympathetic stimulation.
Parasympatholytic. That blocks cholinergic /muscarinic receptor sites causing: increased heart rate, increased conduction through the AV node, reduced motility and GI tone, reduced action and tone of urinary bladder, dilates pupils, suppresses sweating, suppresses lacrimation, suppresses
salivation, suppresses secretions in the upper airways, and can result in bronchodilation.
This drug is indicated for symptomatic bradycardia, and as an antidote for organophosphate poisoning.
Adult Dose of atropine for bradycardia
0.5mg IV/IO/IM, may repeat in 5 minutes to MAX of 3mg / 1.0mg ET.
Nondihydropyridine calcium channel blocker which inhibits calcium ion from entering the "slow channels" or select voltage-sensitive areas of vascular smooth muscle and myocardium during
depolarization, producing a relaxation of coronary vascular smooth muscle and coronary vasodilation; increases myocardial oxygen delivery in patients with vasospastic angina.
To control atrial fibrillation, atrial flutter, and PSVT refractory to adenosine
Indications for Diltiazem
Contraindications of this drug include Sick sinus syndrome, 2nd or 3rd degree heart block, hypotension, wide-complex tachycardia, Wolfe-Parkinson-White syndrome. Use caution in pregnant patients (Cat C), nursing mothers, children, CHF, conduction abnormalities, renal or hepatic impairment, and the elderly.
Contraindications of Diltiazem
Do not use this drug because of increased risk of CHF, bradycardia, and asystole.
Interactions of Diltiazem
Catecholamine/Sympathomimetic. This drug is a naturally occurring neurotransmitter and immediate precursor of norepinephrine. It has effect on alpha, beta, and dopaminergic receptors of the sympathetic ANS. It's actions differ depending on dosage given
A Dopamine dose of 20-40 mcg/kg/min has what effects
alpha effects reverse dilation of renal and mesenteric vessels
This drug is indicated for: Refractory shock, particularly cardiogenic, distributive, or obstructive
Contraindications of this drug include Hypovolemic shock. Adrenal gland tumor. Tachydysrhythmias. Caution should be used in pregnancy (Cat C), in nursing women, and in children.
Adult dose of dopamine.
5-20 mcg/kg/min IV/IO infusion with a 1600 mcg/mL solution. Start infusion at 2-5 mcg/kg/min and increase gradually by 5 mcg/kg/min until desired effect is achieved. Do not exceed 20 mcg/kg/min
This drug is a catecholamine/ sympathomimetic, and is an agonist to alpha and beta adrenergic receptors causing increased chronotrophy, ionotrophy, dromotrophy, bronchodilation, and peripheral vasoconstriction.
Indications for this drug include cardiac arrest. Moderate and severe allergic reactions. Severe refractory wheezing. Pediatric bradycardia with cardiopulmonary compromise.
Adult dose of Epinephrine in cardiac arrest
1 mg IV/IO of 1:10,000 every 3-5 minutes or 2-2.5 mg 1:10,000 ET every 3-5 minutes
Adult dose of Epinephrine in major allergic reactions
0.3 mg 1:10,000 IV/IO push repeat every 5 minutes as needed
This drug is and antidysrhythmic/ anesthetic that suppresses automaticity in the His-Purkinje system and elevates electrical stimulation threshold of the ventricles during diastole. In increased serum concentrations, this drug also has anticonvulsant, sedative, and analgesic effects.
This drug's use is indicated to convert ventricular fibrillation and ventricular tachycardia. To control malignant PVC's.
Decrease maintenance dose of this drug by 50% if patient is in CHF, is > 70 years old, is in shock, or has liver disease
Lidocaine Special Considerations
This electrolyte acts a physiologic calcium channel blocker and blocks neuromuscular transmission by reducing Ach release at the neuromuscular junction.
Calcium chloride or calcium gluconate should be available as an antidote to this drug due to toxicity
Magnesium special considerations
Narcotic analgesic and opiate agonist that causes analgesia and sedation. This drug increases venous capacitance, decreases venous blood return (reduces preload), and reduces systemic vascular resistance at the arteriolar level (reduces afterload) which may lead to decreases in myocardial oxygen demand.
Peak effect of action in this drug, when given IV, is 10 minutes with a duration of 3-5 hours.
This drug is essential for the functional integrity of nervous, muscular, and skeletal systems and cell membrane and capillary permeability. It is also an important activator in many enzymatic reactions and is essential to a number of physiological processes including transmission of nerve impulses, contraction of cardiac, smooth, and skeletal muscles
Dialysis patients in cardiac arrest should be considered to be hyperkalemic and receive
This drug is a polypeptide hormone extracted from animal posterior pituitaries. It possesses pressor and antidiuretic properties. In high doses acts as a non-adrenergic vasoconstrictor that acts by direct stimulation of smooth muscle receptors.
To treat metabolic acidosis in aspirin overdose, tricyclic antidepressant overdose, cocaine overdose and prolonged cardiac arrest resuscitation.
Rapid acting potent sulfonamide loop diuretic that inhibits the reabsorption of sodium and chloride in the Loop of Henle. This drug also causes rapid venous dilation.
The Brain Trauma Foundation has established three criteria for traumatic brain injury patients before:
hyperventilation is appropriate
CVA's that occur as a result of long-term arteriosclerosis and progressive narrowing of the cerebral arteries where a blood clot develops within a cerebral artery or one of the smaller branches are classified as:
An abnormal movement characterized by irregular, unpredictable, involuntary muscle jerks that impair voluntary activity is called:
Which of the following expressions regarding cerebral perfusion pressure is most accurate?
CPP = MAP-ICP
Which letter in the memory aid "AEIOUTIPS" is associated with a patient unconscious from kidney failure?
Which of the following types of seizures is characterized by a loss of interaction, staring off into space, and returning to normal with no memory of the event?
Your 67 year old patient is experiencing slurred speech and notable left side weakness. Her vital signs are: BP-226/112; P-64; RR-16 with a room air SpO2 of 95%. Of the following, which is NOT a goal of the management of this patient?
A. maintain oxygenation
B. early notification and transport to a facility capable of managing stroke patients
C. correct any hypoglycemia
D. reduction of blood pressure
reduction of blood pressure
Which of the following occurs MOST commonly in diabetics?
A. muscular dystrophy
B. spina bifida
C. periperal neuropathy
Which of the following is a demyelinating disease?
A. spina bifida
B. Parkinson's Disease
C. Bell's palsy
D. multiple sclerosis
A patient who opens his eyes to pain, has no verbal response, and withdraws from pain would have a GCS of:
If a patient has a CT scan that shows a dense, white area, then you would suspect that the patient has suffered:
an intraparenchymal hemorrhage
Your patient is a 45-year-old type I diabetic complaining of a 5-day history of abdominal pain, nausea/vomiting, and increased urination and thirst. His skin and mucus membranes are warm and dry. HR =112 bpm and regular, BP = 94/60, RR = 12 and regular. Your treatment for this patient would most likely include:
IV of NS 1-2 L
A 52-year-old female is in moderate distress, complaining of nausea and vomiting. She describes a 3-day history of upper right quadrant abdominal pain. You note that the patient's skin feels warm. She is also positive for Murphy's sign. She called EMS today when she developed nausea and vomiting. She denies any change of bowel habits and states she has a history of alcoholism. Of the following, which is the most likely cause of her clinical condition?
During the examination of an 18-year-old female patient complaining of abdominal pain, the patient denies
nausea, vomiting or diarrhea. She reports a constant, intense pain in her lower abdomen which started two hours ago. Which of the following is the MOST helpful to ask this patient?
When was your last menstral cycle?
Your 67 year old male patient is complaining of abdominal pain and weakness. His vital signs are: BP-72/P; HR-134; RR-28 with a SpO2 of 93% on room air. His 12 lead EKG reveals sinus tachycardia with no indication of acute MI. His skin is pale and diaphoretic. He has a history of hypertension, COPD, and lung cancer. Which of the following should an early consideration for this patient?
abdominal aortic aneurysm
Your 23 year old female patient is complaining of intense abdominal pain. Her vital signs are: BP-72/P; HR-122; RR-28 with a room air SpO2 of 95%. There is no recent history of trauma. She has a medical history of tubal ligation surgery and asthma. Of the following, which do you suspect?
Your patient is a 67 year old male who complains of upper abdomninal pain, nausea, and weakness. In addition to oxygen and IV access, what is MOST important in the pre-hospital setting for this patient?
Your 22 year old patient is complaining of left lower quadrant pain, fever, nausea, and hematochezia. Of the following, you would suspect:
In an elderly, bed-ridden patient with a broken hip, sudden chest pain and dyspnea should suggest:
________ is a severe, prolonged asthma attack that cannot be broken by repeated doses of bronchodilators.
A barrel chest, pink skin coloring, and recent weight loss is characteristic of a patient suffering from -
Your patient is a 9-month-old infant in respiratory distress with grunting respirations of 50 per minute, nasal flaring, and intercostal retractions. He is pale, and you note scattered bilateral wheezing on auscultation of the lungs. The mother states that the child is healthy and up to date on all his immunizations. Which of the following conditions is most likely, based on this information?
Rales, or crackles, may be auscultated in patients with which of the following conditions?
Congestive heart failure
Your patient has profound pulmonary edema, but has a normal blood pressure. No periphereal edema is noted. The patient is afebrile. Which of the following is the most likely cause?
________ is a drop in systolic blood pressure of more than 10 mmHg with inspiration.
Which of the following is LEAST likely to be associated with an acute myocardial infarction?
Chest pain with inspiration
A patient's ECG shows a rhythm at a rate of 64, regular RR intervals, a PR interval of 0.24 seconds, and a QRS of 0.12 seconds. This best fits the criteria for:
first-degree AV block.
Complications of myocardial infarction include all of the following EXCEPT:
A. pulmonary embolus.
B. heart failure.
Release of acetylcholine at the neuroeffector junction of the autonomic nervous system results in a(n):
negative chronotropic effect.
What is LEAST likely to be associated with the pain of acute myocardial infarction?
Pain reproducible with palpation
Which of the following is NOT a likely immediate cause of acute myocardial infarction?
Paroxysmal nocturnal dyspnea may indicate which disease process:
Heart failure, Respiratory infection, COPD
Which of the following occurs during depolarization of a cardiac cell?
A. Potassium moves into the cell.
B. The cell becomes negatively charged.
C. Sodium moves out of the cell.
D. The cell becomes relatively more positively charged.
The cell becomes relatively more positively charged.
Which of the following ECG findings may occur with unstable angina?
A. ST segment depression
B. Q wave formation
C. T wave elevation
D. U wave
ST segment depression
The amount of resistance that must be overcome by the left ventricle during systole is called:
Which of the following is not one of the three pillars of cardiac function as described in our text?
The appearance of a pathological Q wave on an ECG indicates the presence of ________ tissu
Which of the following drugs is indicated for tachycardia that is narrow complexed and regular?
Cardiac ventricular distention just prior to contraction is directly correlated to stroke volume. This principle is called the:
The blockage of a pulmonary artery that stops blood flow to a group of alveoli is called what?
A patient's ECG shows a a rate of 42, regular RR intervals, a PR interval of 0.16 seconds, and a QRS of 0.12 seconds. This best fits the criteria for:
In the treatment of acute pulmonary edema or acute MI the best dosage and frequency of Morphine Sulfate is:
2 to 4mg every 5 minutes PRN
A deficiency of blood supply to the heart to meet myocardial oxygen needs results in a condition called:
Which of the following drugs is used in treating Asystole?
C. Calcium Chloride
A patient's ECG shows a rate of 64, regular RR intervals, a PR interval of 0.24 seconds, and a QRS of 0.12 seconds. This best fits the criteria for:
first-degree AV block
While treating a patient for a suspected MI, You have already put the patient on O2, started an IV, Given Nitro, and morphine. You look at the cardiac monitor and notice Ventricular tachycardia. What should your next action be?
Check a pulse
Chest compressions on your pulseless patient should not be interrupted for a few seconds and only during:
Which part of the pericardium covers the heart and is also known as the epicardium?
Which of the following drugs is indicated for tachycardia that is narrow complexed and irregular?
Which of the following is NOT a typical complication of thoracic aortic aneurysm?
C. Hypovolemic shock
Which of the following beta-blockers acts very rapidly and is, therefore, MOST appropriate in the treatment of hypertensive emergencies?
Your 74 year old patient has called you for back pain. He states that he has a tearing sensation in his back which started several hours ago. He has a history of hypertension, previous CVA, bundle branch block, hyperlipidemia, and CHF. His vital signs are: BP- 178/92; P- 68; RR-28 with an SpO2 of 96% on room air. He has not sustained any traumatic injuries. You note a pulse deficit on his left side and he displays no new neurological deficits. His 12-lead EKG shows a right BBB with no ectopi. What is MOST likely for this patient's present condition?
A patient with an acutely red, swollen, and painful lower limb that is not associated with any trauma is indicative of:
While working on a critcal care transport unit, you recieve a medical order to administer nitroprusside to your 220 lbs patient at 5 mcg/kg/min over a ten minute period to your patient in hypertensive crisis. Your partner has mixed 50mg of nitroprusside in 250 mL of D5W. Using a microdrip set, what is the appropriate drip rate?
Which of the following in NOT indicated for a patient that is suspected of having an acute arterial occlusion of the left leg?
A. administration of morphine
B. elevate the left leg above the level of the heart
C. rapid transport
D. removal of compression hose on the left leg
elevate the left leg above the level of the heart
Which of the following medications is MOST effective in treating hypertensive emergencies by dilating both arterioles and veins?
One of the defining signs of malignant hypertension is papilledema. What does papilledema mean?
swelling of the optic disk
Your 59 year old male patient is complaining of right leg pain and weakness. He tells you that his right thigh aches often while he is resting and always when he tries to walk. His sympotms started about 12 hours prior to your arrival. You note pallor of his right leg compared to his left. He has a history of smoking, hypertension, diabetes, and hyperlipidemia. You suspect:
What effect does chronic hypertension have on the lumen of the vasculature?
causes chronic hypertrophy of vascular endothelium narrowing the lumen
Intermittent claudication in the quadriceps from PAD is MOST similar in pathophisiology to:
angina from exertion
The main concern for a patient with a DVT is the likely development of which life-threatening complication?
Which of the following is NOT an identified risk factor for AAA?
B. tobacco use
C. caffiene intake
D. family history
Which of the following medications used to treat hypertension can cause cyanide toxicity?
An acute marked elevation in blood pressure WITHOUT end-organ damage is best described as
The localized reaction to the thrombosis of a superficial vein characterized by warmth, tenderness and occasionally induration is called:
Which of the following conditions creates a "false lumen" within the walls of the aorta?
Arterial segments that are permantly dilated 1.5 times the diameter of the adjacent artery are called:
Which of the following is generally NOT associated with hypertensive emergencies?
A. damage to occular function
B. malignant nephrosclerosis
C. reduced proteninuria
D. damage to kidney function
Which propert of cardiac cells is best described as the ability to respond to an electrical stimulus?
The ability of cardiac cells to transmit electrical impulses from cell to cell is referred to as the property of:
What are the three positively charged ions responsible for initiating and conducting electrical signals in the heart.
Sodium (Na+), Calcium (Ca2+), Potassium (K+)
The resting cell normally has a net negative charge with respect to the outside of the cell. What is this state called?
What term is used to refer to the process of electrical discharge and the flow of electrical activity
In a cardiac cell the electrical charges are provided primarily by which two electrolytes
sodium and potassium
When stimulated, this branch of the nervous system will increase heart rate, AV conduction, and irritability.
These structures form branching networks and are barely the diameter of a single red blood cell.
which movements of skeletal muscles near a vein compress it, helping push blood toward the heart.
This is the network of blood vessels that carries blood to and from the rest of the body.
Which connective tissue divides the thoracic cavity into two pleural cavities and encloses the heart?
Which part of the pericardium covers the heart and is also known as the epicardium?
These are specialized sites that allow cardiac muscle cells to rapidly transmit electrical impulses
These are the connective tissue fibers that brace the flaps of the tricuspid valve
What is another name for the conductive pathway between the AV node and the bundle branches?
Bundle of His
The general rule of "more in equals more out," or the greater the amount of blood entering the ventricle, the greater the contraction, is referred to as the:
If the ectopic impulse arises from the middle of the right atrium the P' wave is
less positive than one that originates from the upper-right atrium.
P' waves that continuously change in appearance indicate that the
impulses are arising from different locations in the atria.
Premature beats that arise from the atria or internodal pathways produce P' waves that
may be obscured or buried in the T wave of the preceding beat.
When there are more P waves than QRS complexes it indicates that
the atria are firing so fast that not all the impulses can pass through the AV node and some are blocked.
Inverted P' waves occur when the
electrical impulse originates in or near the AV junction and travels upward into the atria causing retrograde depolarization.
A PR interval of less than 0.12 seconds indicates
a pacemaker site which is either in or close to the AV junction.
With 2nd-degree AV heart block, Type II, the PR intervals associated with the P waves which are followed by a QRS complex will be
The S wave in the QRS complex is
the negative deflection that follows the R wave and extends below the baseline.
A PR interval of greater than 0.20 seconds indicates
a delay in conduction of the impulse between the SA node and the ventricles.
When the P waves seem to "march through" the QRS complexes it indicates
a complete blockage of the AV node
The PR interval is the distance from the beginning of the __ to the beginning of the__.
P wave, Q wave
A complex that comes early in the rhythm that appears to be initiated from outside of the SA node:
Must be caused by ectopy
This man, Napoleons chief surgeon, wrote the earliest recorded specifications for ambulances
Dr. Dominique-Jean Larrey
In the United States, the development of the ambulance and the first ambulance system occurred during which war
The Civil War
As a response to the disaster at Bull Run, this type of ambulance was designed.
The Rucker ambulance
This is the first time trauma was officially recognized and classified as a disease process.
White Paper - 1966
Defined legally as the behaviors expected of similarly trained, competent individuals within a profession
Standard of Care
in what type of situation is it important to determine if the patient is both legally, and mentally competent.
Any refusal situation
The failure to act as a reasonably prudent and careful person would under similar circumstances
Placing a patient in a position where he fears for his safety or perceives you mean to cause him harm
The confinement of a person against his or her will or without the persons consent
saying or publicizing something untrue about a person that tends to injure that persons character.
What layer of the of the gastrointestinal (GI) system is made up of smooth muscle that contracts
progressively from the esophagus to the colon?
The salivary glands include all EXCEPT the _______ gland.
What is the thick ring of smooth muscle between the stomach and the small intestine called?
Pepsin, which is an enzyme found in the stomach, is important in the initial breakdown of:
Hormones produced by the endocrine cells of the stomach and intestine have significant effects on
the motility of substances. Gastrin has what effect on stomach secretions and emptying?
The common bile duct and the hepatic duct drain into the opening of the duodenum at the:
ampulla of Vater.
Which of the following is NOT one of the functions of the liver?
A. Removal of red blood cells
B. Storage of glucose
C. Protein synthesis
D. Filtering body wastes from blood
Removal of red blood cells
Lymph is a thin plasma-like fluid formed, in part, from which of the following fluids?
The spleen consists of two types of lymph tissue. The venous drainage of the spleen is what type
A response to a given substance that is faster and stronger after subsequent exposures is called a
Which type of specific immunity is achieved by actions of T lymphocytes (T cells)?
Which of the following is NOT a type of leukocyte that may play a role following infection of
various areas in the body?
The human immunodeficiency virus (HIV) adversely affects a protein on T helper cells called the:
Tuberculosis (TB) is an infectious disease that is spread through what kind of transmission?
T/F: A patient with a depressed immune system can be severely affected by exposure to a minimal infectious disease
What kind of boundary does diffuse lymphatic tissue share with surrounding tissues?
No clear boundary
A nonspecific response is an immune response that is _______ each time the body is exposed to
a particular challenge.
Which of the following does NOT help continuously wash away foreign matter?
Which lobe plays an important role in hearing and memory and is separated from the rest of the
cerebrum by a lateral fissure?
The V cranial nerve supplies sensation to the scalp, forehead, face, and lower jaw via three
branches and provides motor innervation to the muscles of the throat and inner ear; this nerve
ear is also called the _______ nerve.
The nervous system is divided into a number of systems. Name them.
Central (Autonomic (sympathetic, parasympathetic) and peripheral
You respond to a patient in a nursing home, and while getting a SAMPLE history you are told
about a subarachnoid hemorrhage that occurred a few years before. Where did that hemorrhage
Between the arachnoid and pia mater
The dispatcher informs you that you have call for respiratory distress. While responding, you
receive a radio report from a first responder on the scene giving you patient information. The
report includes that the patient is a smoker with a history of COPD. Based on the pathophysiology
of this disease, which other piece of information is MOST likely to be included in the first
responder's radio report?
Symptoms increased gradually over days
You respond to a report of a 14-year-old female patient who is reported having difficulty
breathing. Upon arrival you find that she is having difficulty breathing, and her mother tells you
that the girl has asthma. You consider which events occur with an asthma attack in order to
develop a plan of treatment. Which would you NOT expect with an asthma attack?
Decreased secretion of mucous
The inferior portion of the midbrain coordinates heart rate, blood vessel diameter, swallowing,
vomiting, and coughing and is called the:
You are treating a 24 year old male who has fallen from a height of 20 feet onto concrete. The
patient is unresponsive with an intact gag reflex. The only sign of trauma is a depression in the
occipital region. His vital signs are: BP 190/92, P 62, R 12 with an SpO2 of 97% on room air. You
note that his pupils are 5mm and sluggish. You should
maintain the patient's blood pressure.
Which adrenergic receptor effects occur in the peripheral blood vessels, causing vasoconstrictions?
A patient with black lung disease and asbestosis may demonstrate a significant decrease in vital
restrictive lung disease.
Electrical impulses travel down the nerve and trigger the release of chemicals known as:
Neuroglia cells have a number of basic functions, except...
Facilitate electrical impulses through neurons
This type of cell protects cell membranes of neurons, regulate composition of interstitial fluid, and defend neural tissue from pathogens.
How a drug is transported into, inside, and out of the body absorbed, distributed metabolized (biotransformed and excreted
Name for the discoloration around the umbilical area That indicates an intra abdominal bleed
The body's response due to cerebral ischemia increase in systemic BP, which maintains cerebral perfusion during IICP
Occurs when a newborn is startled by a noise or sudden movement, the infant reacts by flinging the arms and legs outward and extending the head.
When the infants palm is touched and whe an object is placed across the palm. the infants hands grip tightly.
When the sole of the infant's foot is stroked on the outside from the heel to the toe, the infant's toes fan out an curl and the foot twists inward.
When the infant is held so that the feet are flat on a surface, the infant will lift one foot after another in a stepping motion.
A radio system that allows transmitting and receiving at the same time through two different frequencies.
Describes a radio system that can use the components of several different systems; it can use specialized equipment to connect several different radio systems and components together and have them communicate with each other.
A system that allows the crew to transmit voice and data at the same time, enabling the crew to call in a patient report while transmitting an ECG strip to the hospital.
A system that receives transmissions from a low-wattage radio and rebroadcasts the signal at a higher wattage to the dispatch center.
A system that allows only one at a time communication. The transmission cannot be interrupted; both operators use the same frequency.
A system that uses multiple repeaters (five or more) so that the computer can search for an open channel to transmit by.
Paramedics are at an elementary school where a child has sustained minor injuries, and the school nurse insists on sending the child to the emergency department. What type of consent is this?
r on t phenomenon
ventricular depolarization falling somewhere within a T wave. Can result in v-tach or v-fib.
What does Renin do in the renal system?
It initiates the renin-angiotensin to raise the blood pressure, the end product being angotensin II
Purpose of ADH?
It allows the distal convoluted tubules and collecting tubules to reabsorb more water from the filtrate. Helps maintain body volume and BP
What does the upper respiratory tract consist of?
Nose, nasal cavity, pharynx, larynx, and upper trachea
What does the lower respiratory tract consist of?
Lower trachea and the lungs, which include the bronchial tubes and alveoli
Amount of air, beyond tidal volume, that can be taken in with the deepest possible inhalation
Amount of air that remains in the lungs after the most forceful exhalation; exchange of gases is a continuous process
scraping or abrading away of the superficial layers of the skin; an open soft-tissue injury
type of generalized seizure with sudden onset, characterized by a brief loss of awareness and rapid recovery
period of the cardiac cycle when stimulation will not produce any depolarization whatsoever
absolute refractory period
acquired immunity that occurs following exposure to an antigen and results in the production of antibodies specific to the antigen
a marker on the surface of a cell that identifies it as "self" or "non-self" and that is capable, under appropriate conditions, of inducing a specific immune response
breathing characterized by a prolonged inspiration unrelieved by expiration attempts, seen in patients with damage to the upper part of the pons
response in which an injured cell releases enzymes that engulf and destroy itself; one way the body rids itself of damaged and dead cells
application of the forces of trauma along the axis of the spine; this often results in compression fractures of the spine
What is another name for sensory neurons? And what is their purpose?
Afferent neurons. Carry impulses from receptors to the CNS
What is another name for motor neurons? And what is their purpose?
Efferent neurons. Carry impulses from CNS to effectors
Located between the spinal cord and the pons. Control of vital signs and reflex center is located here as well. Coughing, sneezing, vomit, swallowing
This part of the brain is responsible for respiratory control of rhythms and patterns, it tries to compensate for medulla
This part of the brain is responsible for visual/auditory reflexes (hearing a bee) and equilibrium/balance (keeping upright)
Related to abnormality in vascular tone arising from several different scenarios
distributive shock (vasogenic)
What other types of shock are included into Distributive?
Neurogenic, psychogenic, septic, and anaphylactic
What does the heart do during hypovolemic shock?
It increases cardiac output by increasing strength and rate of contractions caused by the release of epi
In Septic shock, what is released in response to the infection?
Cytokines, which cause damage to the walls of the blood vessels, vasodilation, and leakage of fluid from capillaries
What hormone is indirectly responsible for increasing Blood Pressure due to the absorbing of sodium?
What hormone is directly responsible for increasing Blood Pressure due to the increase absorption of water in the kidneys?
The ______________ branch of the autonomic nervous system innervates all three pacemaker sites and the working cells of the heart.
The blood from the right ventricle travels through what valve before going into the pulmonary artery?
After the blood is oxygenated in the alveoli of the lungs, it returns to the left atrium via the...
The ability of the cells within the cardiac conduction system to generate a cardiac impulse on their own
The period during the normal beating of the heart in which the chambers of the heart, especially the ventricles, contract to force blood into the aorta and pulmonary artery.
What does the PRI represent?
the time it takes the heart's electrical impulse to travel from the atria to the ventricles
a rigid stretcher commonly used in technical and water rescues that surrounds and supports the patient yet allows water to drain through holes in the bottom. Also called a stokes litter
A carrying technique in which one emt is located at the head end, one at the foot end, and one at each side of the patient; all face forward as they walk
a lifting technique used for the patients who are found lying supine on the ground with no suspected spinal injury
Direct ground lift
a move in which the patient is dragged or pulled from a dangerous scene before initial assesment and care are provided.
a lifting technique for patients who are supine or in a sitting position with no suspected extremity or spinal injuries
A stretcher that is a rigid carrying device when secured around a patient but can be folded or rolled when not in use.
a stretcher with a strong rectangular tubular metal frame and rigid fabric stretched across it
The back board is gripped by inserting each hand inder the handle with the palm facing up and the thumb extended, fully supporting the underside of the handle on the curved palm with the fingers and thumb
A lifting technique in which the EMT's back is held upright, with legs bent, and the patient is lifted whtn the EMT straightens the legs to raise the upper body and arms
A technique to move a patient from a sitting position inside a vehicle to supine on a backboard in less than one minute whrn conditions do not allow for standard immobilization
Rapid Extracation technique
a stretcher that is designed to be split into two or four sections that can be fitted around a patient who is lying on the ground; also called a split stretcher
a specially designed stretcher that can be rolled along the ground. A collapsible under carriage allows it to be loaded into the ambulance. also called and ambulance cot.
Wheeled Ambulance stretcher
Fixed-wing aircraft and helicopters that have been modified for medical care; used to evacuate and transport patients with life threatening injuries to treatment facilities
The designated area in a hazardous materials incident where all patients and rescuers must be decontaminated before going to another area
Complicated entry that requires special tools and training and includes breaking windows or using other force.
An area where individuals can be exposed to electrical hazards such as sharp metal edges, broken glass, toxic substances, lethal rays, or ignition or explosion of hazardous materials. OR The area immediately surrounding a HazMat site that is directly dangerous to life and health
Danger (hot) Zone
Removal of a patient from entrapment or a dangerous situation or position, such as removal wrecked vehicle, industrial accident, or building collapse.
Any substances that re toxic, poisonous, radioactive, flammable, or explosive and cause injury or death with exposure
Incident Commander (IC)
The individual who has overall command of the incident in the field
Incident Commander (IC)
A hostage, robbery or other situation in which armed conflict is threatened or shots have been fired and the threat of violence remains
A team of individuals from one or more departments in a region who are trained and on call for certain types of technical rescue
Technical rescue group
A rescue that requires special technical skills and equipment in one of many specialized rescue areas, such as technical rope rescue, cave rescue and dive rescue.
Technical rescue situation
An area set up by physicians, nurses, and other hospital staff near a major disaster scene where patients can receive further triage and medical care.
Casualty collection area
a safe area at a hazardous materials incident for the agencies involved in the operations. The incident commander, command post, EMS providers, and other support functions necessary to control the incident should be located in the cold zone, also referred to as the clean zone or the support zone.
In incident command, the position that oversees the incident, establishes the objectives and priorities, and from there develops a response plan.
The designated field command center where the incident commander and support personnel are located
the process of direction responders to return to their facilities when work at a disaster or Mass-casulity incident has finished, at least for those particular responders
rA widespread event that disrupts community resources and functions, in turn threatening public safety, citizens' lives and property
barrel-like containers used to store a wide variety of substances, including food-grade materials, corrosives, flammable liquids, and grease
A preliminary action guide for first responders operating at a hazardous materials incident in coordination with the US Dept. of Transportation's labels and placards marking system
Emergency Response Guidebook
In incident command, the person appointed to determine the type of equipment and resources needed for a situation involving extrication or special rescue; also called rescue officer
In incident command, the position in an incident responsible for accounting all expenditures
When individual units or different organizations make independent and often inefficient decisions about the next appropriate action
An incident in which a hazardous material is no longer properly contained and isolated
Hazardous materials (HazMat) Incident
An oral or written plan stating general objectives reflectin the overall strategy for managing an incident
Incident Action Plan
A system implemented to manage disasters and Mass casualty incidents in which section chiefs, including finance, logistics, operations, and planning, report to the incident commander
Incident command system (ICS)
An area designated by the IC, or a designee, in which public information officers from multiple agencies disseminate information about the incident
Joint information center
A sorting system for pediatric patients younger than 8 years or weighing less than 100 lb. There is a minor adaptation for infants since then cannot walk on their own.
In Incident command, the person who relays information, concerns, and requests among the responding agencies
In incident command, The position that helps procure and stockpile equipment and supplies during an incident
An emergency situation involving three or more patients or that can place great demand on the equipment or personnel of the EMS system or has the potential to produce multiple casualties.
Mass-casualty Incident (MCI)
A form, provided by manufacturers and compounders of chemicals containing information about chemical composition, physical and chemical properties, health and safety hazards, emergency response, and waste disposal of a specific material
Material safety data sheet (MSDS)
A branch of operations in a unified command system, whose three designated sector positions are triage, treatment, and transport
Medical incident command
In IC, the person who works with area medical examiners, coroners, and law enforcement agencies to coordinate the disposition of dead victims
An agreement between neighboring EMS systems to respond to MCIs or disasters in each other's region when local resources are insufficient to handle the response
Mutual aid response
A department of Homeland Security system designed to enable federal, state, and local governments and private sector and nongovernmental organizations to effectively and efficiently prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size or complexity, including acts of catastrophic terrorism
National Incident Management System (NIMS)
In IC, the position that carries out the orders of the commander to help resolve the incident
Measures of the amount and type of protective equipment than an individual needs to avoid injury during contact with a hazardous material
Personal Protective Equipment (PPE) levels
Signage required to be placed on all four sides of highway transport vehicles. The sign identifies the hazardous contents of the vehicle
A type of patient sorting used to rapidly categoryize patients; the focus is on speed in locating all patients and dertermining an initial priority as their conditions warrant.
In IC, ther person who keeps the public informed and relates any information to the press.
Public information officer (PIO)
the area that provides protection and treatment to fire fighters and other personnnel working an emergency. Here, workers are medically monitored and receive any needed care as they enter and leave the scene.
in IC, the person who establishes an area that provides protection for responders from the elements and the situation.
In IC, the person who gives the "go ahead" to a plan or who may stop an operation when rescuer safety is an issie.
An engineered method to control spilled or released product if the main containment vessel fails.
A type of patient sorting used in the treatment sector that involves retriage of patients.
single command system A command system in which one person is in charge, generally used with small incidents that involve only one responding agency or one jurisdiction.
single command system
In IC, the subordinate positions under the commander's direction to which the workload is distributed; supervisor/worker ratio
Span of control
In IC, the person who locates an area to stage equpiment and personnel and tracks unit arrivial and deployment from the staging area
patient sorting process limited to assessing the patients ability to walk, respitory status, hemodynamic status, and neurologic status --Simple Triage And Rapid Treatment
Measures the risk that a hazardous material poses to the health of an individual who comes into contact with it
The area in an MCI where ambulances and crew are organized to transport patients from the treatment area to receiving hospitals
The individual in charge of the transportation sector in a MCI who assigns patients from the treatment area to awaiting ambulances in the trasnport area.
The individual usually a physician, who is in charge of and directs EMS personnel at the treatment area in a MCI
The process of sorting patients based on the severity of injury and medical need to establish treatment and transportation priorities
The individual in charge of the incident commandtriage sector who directs the sorting of patients into triage categories in a MCI
A command system used in larger incidents in which there is a multiagency responce or multiple juridictions are involved
Unified command system
the area locates betwwn the hot zone and the cold zone at a HazMat incident. The decontamination corridor is located in the warm zone.
A type of energy that is emitted from a strong radiologic source; is slightly more penetrating that alpha and requires a layer of clothing to stop it.
Severe(RED)- Severe Risk, High(ORANGE)- High Risk, Elevated(Yellow)- Significant Risk, Guarded(BLUE)-General Risk, Low(GREEN)- Low Risk
Terrorist threat levels
A type of energy that is emitted from a strong radiologic source; it is the least harmful penetration type of radiation cannot travel fast or through most objects.
A disease caused by deadly bacteria that lay dormant in a spore. The germ is released from the spore when explodes to the optimal temperature and moisture.
The process by which the temporary bond between the organophosphate and acetylcholinestrarase undergoes hydrolysis, resulting in a permanent covalent bond.
What term is used to describe the condition in which blood accumulates in the pleural space
A hemothorax occurs when blood accumulates in the pleural space
___ ___ is part of a syndrome called chronic obstructive pulmonary disease (COPD)
___ ___ is usually caused by viruses or bacteria and may last several days or weeks.
a group of diseases characterized by the pathological limitation of airflow in the airway that is not fully reversible.
A PASG is contraindicated if the patient presents with cardiogenic shock or _______.
abnormal lung sounds
a policy or protocol issued by a medical director that authorizes EMTs to perform particular skills in certain situations
After delivering your first shock with an AED, the patient is still pulseless, you should next
perform two minutes or 5 cycles of CPR
An infant or child patient who exhibits wheezing, increased breathing effort on exhalation, or rapid breathing without stridor probably has:
A lower-airway disease
caused by loss of elasticity of the lung tissue, from destruction of structures supporting the alveoli, and destruction of capillaries feeding the alveoli.
Chaotic electrical activity originating from many sites in the heart is called:
Glaucoma, shock other than anaphylactic, diabetes, cardiac problems, hypertension, pregnancy, meds include a beta blocker or MAOI
If a patient is eight months pregnant, how much blood can she potentially lose before exhibiting signs of shock?
If the patient is not defibrillated within _______ minutes of a cardiac arrest, there is almost no chance for survival.
In the condition called ____, there is not electrical stimulus to cause the heart muscle to contract.
occurs when an object migrates from one part of the body and causes a blockage of a blood vessel in another part of the body
Prior to delivery, if the mother is in the supine position, she may develop dizziness and a drop in blood pressure. This is called:
supine hypotensive syndrome
Signs of internal bleeding include:
Bruising, swelling, and pain over vital organs; painful, swollen, or deformed extremities
Splinting a closed, angulated fracture in the position in which it was found may cause a(n) _______ during transport.
The condition of excessive fluid buildup in the lungs because of the inadequate pumping of the heart is called
the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system
Type _ diabetes usually develops in childhood, and requires at least daily doses of supplemental insulin.
When gases enter the bloodstream as the result of a damaged lung, it is called a(n)
arterial gas embolism
When pressure increases inside the skull because of swelling of brain tissue, blood flow is decreased. This results in...
the brain being starved for oxygen and carbon dioxide increasing, causing more swelling.
Which body parts are considered to be 9% of total body surface area
head, chest, abdomen, both arms, each leg
Occurs when the body's cooling mechanism have been expended
Skin is normal to cool in temp
Pale or Grey in color
muscle pain or spasm due largely to the loss of salt from the body from sweating, or inadequate intake of salt
A knife or other impailed object in the body exerts damage to the immediate area of impact and it's underlying structures. The length of the object used is important
Low velocity injuries
Med/High velocity projectiles are from pellets or bullets. The damage caused, depends on the Trajectory and the dissipation of energy. Dissipation of energy is affected by Drag,Profile,Cavitation, & Fragmentation.
Medium and high velocity injuries
Injuries due to the pressure wave of the blast. Injuries primarly effect the gas-containing organs, such as the lungs, stomach, intestines, inner ears and sinuses. Death may occur from this stage w/o any sign of external injury
Primary phase injuries
Injuries due to flying debris propelled by the blast
They are usually lacerations fracture burns
Secondary phase injuires
Injuries due to being throw and then landing on the ground similar to being ejected out of a car
Tertiary phase injuries
a burn that involves only the epidermis, the outer layer of the skin. It is characterized by reddening of the skin and perhaps some swelling
Superficial burn - 1st degree
a burn in which the first layer of skin (epidermis) is burned through and the dermis (second layer) is damaged. Burns of this type cause reddening, blistering, and a mottled appearence.
Partial thickness burn - 2nd degree
a burn in which all the layers of the skin are damaged. There are usually areas that are charred black or areas that are dry and white
Full thickness burn - 3rd degree
first stage of labor; the uterine muscle contracts strongly to expel the fetus; the fetus presses on the cervix and causes it to dilate or expand
Umbilical cord around the neck; assess by as soon s the head is out of the vagina, run index finger around the neck; if unable to stretch over the babies head, clamp cord 2" apart and cut, then deliver as normal.
The process of movement of a drug from the site of application into the body and into the extracellular fluid compartment is known as:
Medical control orders an IV lidocaine bolus to control the PVC's. What is the dose?
1.0-1.5 mg/kg first dose, and 0.5-0.75 mg/kg second dose
As a paramedic, if you are given a verbal medical order for drug administration by a medical
control physician which you believe will harm your patient, you should:
Withhold the drug, inform the medical control physician the
reason for withholding the drug, and document the
Small amounts of opiates, such as opium, dihydrocodeine, and diphenoxyate, when used as
antitussives or antidiarrheals in combination products are usually classified as:
What classification would a drug be that has a high potential for abuse, and has no currently accepted medical use in treatment in the United States.
What classification would a drug be that have a currently accepted medical use in treatment in the United States, or currently accepted medical use with severe restrictions, and abuse of the drug or other substances may lead to severe psychological or physical dependence.
This classification of substances are those that have a currently accepted medical use in treatment in the United States, and abuse of the drug or other substance may lead to moderate or low physical dependence or high psychological dependence. ie. anabolic steroids, vicodin, or tylenol 3
A drug for which animal studies have not demonstrated a risk to the fetus, but there are no
adequate studies in pregnant women would be which pegnancy category?
A drug for which adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
A drug for which animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
A drug for which there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
A drug for which studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
Your patient shows you an unfilled prescription which states, "ASA 81mg po qd a.c.". This
take 81 milligrams of aspirin by mouth every day before
Medical control orders dopamine at 5mcg/kg/min for your 176lbs patient. You add 400mg of
dopamine to 250mL of NS. If you use a microdrip set, what is the drip rate?
Your patient is in cardiac arrest and you are unable to establish IV access. However, an ET has
successfully been placed. So, you could give your patient:
2.5 mg epinephrine ET diluted in 8-10 mL NS
A hypertensive patient is given two different drugs to control his blood pressure at different
times to determine which drug is best suited for the patient. If drug A consistently lowers the
patient's blood pressure more effectively than drug B, then:
Drug A has higher efficacy than drug B
Medical control orders an infusion of amiodarone at 1mg/ min. If you mix 150mg in a 500cc bag
of NS and use a 15gtt/mL set, what is the appropriate drip rate for your 220lbs patient?
What is the dose for magnesium sulfate to treat Torsades de Pointes in an adult?
2g in 250mL IV/IO infusion
You are ordered to administer 50mcg/kg/hr of glucagon to your beta-blocker overdose patient
that weighs 88 lbs. If you mix 4mg of glucagon in 100mL and use a microdrip set, what is the
proper drip rate?
The body's tendency to maintain all of its physiological activities in proper balance is called:
What is the name of the process in which "helper proteins" on the surface of the cell are required
to move substances across the cell membrane?
In 1983, Congress passed a law which offers substantial tax credits to companies that develop:
You are dispatched to a local home improvement wharehouse on "general illness". You arrive on
the scene to find a 22 year old male responsive to voice, who has been vomiting. You note
evidence of incontinance and diaphoresis. He was unloading a cargo truck of garden supplies at
symptom onset. His initial vital signs are: BP-88/P; P-62; RR-28. You suspect:
What is the correct adult dose for atropine to treat organophosphate poisoning?
2 mg IV/IO/IM q 5 min prn
The legislation in the United States that classifies drugs into five different schedules is known as:
The Controlled Substance Act of 1970
The first federal law regulating labeling foods and drugs containing certain drugs including cocaine and heroin and also recognized the U.S. Pharmacopeia and the National Formulary as standards authorities for drugs
1906 Pure Food and Drug Act
a set of laws passed by Congress giving authority to the U.S. Food and Drug Administration (FDA) to oversee the safety of food, drugs, and cosmetics.
Federal Food, Drug, and Cosmetic Act 1938
A 74 year old female is complaining of shortness of breath. Her skin is normal temperature and
moisture, and she denies any pain or nausea. Her lung sounds are clear bilaterally. Should you give this patient Albuterol?
Medical control orders an infusion of D5W at 90mL/hr for your 110lbs patient. If you use a
10gtt/mL set, what is the appropriate drip rate?
A drug which never reaches market because it's not profitable to the manufacturer, is sometimes
While gathering a SAMPLE history on your chest pain patient, you note that he is taking beta blockers
Suddenly, your patient collapses in cardiac arrest. How would you expect this patient to respond
to epinephrine as compared to other patients?
epinephrine will not be as effective
These are factors which affect drug absorption
Bioavailability, Drug pH, and Concentration of the drug
For a severe allergic reaction, you should give your adult patient
0.3 mg epinephrine 1:10,000 IV/IO
For a moderate allergic reaction, you should give your adult patient
0.3 mg epinephrine 1:1000 IM/SC
What is the principle neurotransmitter of the sympathetic nervous system at the post-ganglionic
One advantage of giving a drug through a parenteral route is:
Absorbed dosage and action are more predictable than
describes the introduction of nutrition, a medication, or other substance into the body via a route other than the mouth, especially via infusion, injection or implantation
Which drug should be given very slowly when giving an IV bolus to a patient NOT in cardiac arrest?
Medical control orders an Isuprel drip at 0.1mcg/kg/min for 75lbs patient. You mix 1mg Isuprel in 250mL of D5W. If you use a microdrip set, what is the appropriate drip rate?
Vagal manuevers can be useful in treating patients experiencing
tachycardias originating in the atrias
After giving your anaphylactic patient a subcutaneous injection of 1:1000 epinephrine, you
notice a small bubble of fluid under the skin at the injection site. You should:
realize that this is normal for a SC injection, document the
time and dose, and observe your patient for effects
After the FDA approves a drug for one indication, a physician legally may prescribe it, a
pharmacist may dispense it, and a nurse or paramedic may administer it for:
for any labeled or unlabeled indications
Which drug should be used to convert PSVT associated with Wolfe-Parkinson-
White Syndrome that is refractory to vagal manuevers?
The law that originally required a label on drugs that accurately described the package's contents
Federal Food, Drug, and Cosmetic Act of 1938
Which adrenergic receptor effects occur in the peripheral blood vessels, causing
The plasma level of a drug at which severe adverse reactions are expected or likely is called:
If you were to instruct your patient to bear down as if having a bowel movement, you would
expect for them to respond by stimulation of:
the parasympathetic system
An example of a drug that acts by chemically combining with other substances would be:
Which adrenergic receptor is responsible primarily affects the lungs, causing bronchodilation?
A test that determines the amount and purity of a given chemical in a preparation in the
laboratory is called a(n):
Normally, hepatic failure will increase a drug's _________________because the drug's
____________ rate is diminished.