An EMT’s most important functions are
assessing the patient plus providing emergency care and transport to a medical facility.
Assessment most important
In completing a modified assessment of the lower extremities of a stable patient's who fell, what should the EMT be sure to include?
Significant mechanisms of injury for an adult include:
Seatbelt injuries seatbelt injuries noted to the abdomen and shoulder areas.
Which of the following is considered inadequate breathing?
The first component of patient assessment is
Steps of the scene size up
A primary assessment is conducted on every patient regardless of the mechanism of injury or nature of the illness.
The main purpose of the primary assessment is to
identify and manage immediately life-threatening conditions to the airway, breathing, oxygenation, or circulation.
Any life-threatening condition that is identified must be treated immediately as found—before moving on to the next portion of the primary assessment.
Components of a primary assessment are...
The key to primary assessment is
making sure to assess and manage any immediate life threats to the airway, breathing, oxygenation, and circulation during the first 60 seconds after encountering the patient.
Steps of the primary assessment
Forming a general impression
steps taken to keep the spine in anatomic alignment and to restrict movement of the spine to prevent further injury when an existing spinal injury is suspected.
spine motion restriction methods
steps taken by a patient, without assistance, to keep his head, neck, and spine in alignment and to restrict or prevent their movement.
If not = cervical collar
All of the following assessment findings are indications for a 10-minute-or-less on-scene time and rapid transport, EXCEPT:
puncture wound to the forearm with controlled bleeding
Which of the following components is NOT part of the secondary assessment of a trauma patient who is stable?
For which of the following patients is it most important that the EMT perform a full neurological examination as a part of the secondary assessment?
The patient whom you suspect may have injured his neck in a car collision.
When determining the mental status during the primary assessment, what is typically determined FIRST in the patient?
Which of the following is TRUE about the inspection of the abdomen in a patient who sustained blunt abdominal trauma?
Discoloration around the navel and in the flank area usually appears several hours after the injury.
What is the first phase of patient assessment that the EMT should do at each and every patient encounter?
An absence of breathing is called
A large puncture wound or laceration to the neck must be immediately sealed with an occlusive dressing to prevent:
What are the important assessment parameters in determining the circulation status in a 25-year-old male who was shot in the leg, after the major bleed was controlled?
Color, temperature, and condition of the skin
You are treating a patient who has chest pain and difficulty breathing. The secondary assessment should evaluate, at a minimum, the:
What is the first portion of the secondary assessment for a medical patient who is responsive and stable?
While performing a rapid trauma assessment of a patient, you note a clear fluid leaking from the ears. This can indicate what significant injury?
A possible skull fracture
You arrive on scene and complete the scene size-up on an unresponsive patient. What should you consider doing next?
Assess the patient's airway patency.
While assessing the pulse in a patient as you determine the vitals, which of the following should you be sure to ascertain?
Rate, location, strength, and regularity
Which of the following findings would be considered critical in assessing the chest of a patient during the secondary assessment?
What should the EMT do if a patient is complaining of dyspnea, has ashen nail beds, and has a pulse ox of 95 percent on room air?
You are examining an otherwise healthy 20-year-old male jogger who tripped on a curb and fell onto the sidewalk. You note a possible fracture to his right wrist, and he complains of slight pain in his elbow. He denies any loss of consciousness, and there is no external bleeding. What would be the priority of this patient?
An unresponsive medical patient requires airway management. Which of the following is TRUE regarding airway control of the unresponsive medical patient?
Manual airway maneuvers helps to prevent the tongue and epiglottis from blocking the airway of an unresponsive patient.
During your assessment of a patient suspected of having a stroke, you find that you have to pinch the nail beds or the trapezius muscle in order for him to have a muscular response. This is what type of stimuli response in accordance with the AVPU scale?
Patient responds to painful stimuli.
Which of the following findings, individually, would be sufficient to classify a trauma patient as a high priority?
If, during the secondary assessment, you are examining the skin color, temperature, and condition; jugular venous distension (JVD); and ankle edema, you are likely assessing a patient with a(n):
Once the scene is safe and controlled, you prepare to begin the primary assessment of the patient. Which of the following is TRUE regarding the primary assessment?
Critical conditions identified during the primary assessment must be treated immediately as found.
During the primary assessment, you are listening for sounds that may indicate partial airway obstruction. Each of the following may be heard in the patient with partial obstruction, EXCEPT:
What is the first component that is performed in completing the secondary assessment of a medical patient who is alert and oriented?
If you are computing a Revised Trauma Score, and the patient's GCS score is 14 with a respiratory rate of 30/min, a blood pressure of 102 systolic, and a heart rate of 104, what is the patient's total revised trauma score?
What process would you use to further evaluate the chief complaint of the responsive medical patient?
You arrive on the scene of an automobile collision and find one of the drivers suffering from multiple injuries and an altered level of consciousness. After completion of the primary survey, you should next:
A.
complete a rapid secondary assessment.
What would be considered a significant mechanism of injury for an infant?
A fall greater than 10 feet
As soon as the patient's airway is opened, which of the following is NOT part of what the EMT should consider doing NEXT?
Determine the need for spinal immobilization.
You should administer oxygen via face mask or cannula to an adequately breathing patient with:
A.
a pulse oximeter reading of 92 percent and chest discomfort.
What is typically one of the initial interventions provided, once EMS arrives, for an unresponsive patient who has been injured by a fall?
Manual stabilization of the cervical spine
While on scene with a trauma patient, when should the EMT consider requesting ALS backup?
Whenever your patient's airway is compromised
When performing a secondary assessment on a trauma patient with a significant mechanism of injury, what type of secondary assessment should the EMT perform?
Rapid secondary assessment
Which of the following statements is TRUE regarding the secondary assessment for an unresponsive medical patient?
It is very similar to the secondary assessment for a trauma patient with a significant mechanism of injury.
You are transporting a patient who was injured as he was jogging along a road and was struck by a car. The patient has a GCS score of 10 with a respiratory rate of 30/min and a blood pressure of 78 systolic. The heart rate is 124/min. What is the patient's total revised
trauma score?
You arrive on scene for a patient who is trapped in a car after an MVC. From the ambulance, you can see the male patient slumped over the steering wheel with blood coming from a large head laceration. There is also smoke billowing from under the hood. What should you do first?
Complete a full scene size up
What does the EMT know about the modified medical assessment of a stable patient?
MT knows that it is directed by the patient's complaints
Which of the following circulation assessment findings best describes a hemorrhage that the EMT should manage immediately?
Heavy venous/arterial bleeding from the thigh due to a penetration injury
Which of the following components is NOT used during the evaluation of the Revised Trauma Score?
You are working with a new EMT and while on scene with an unresponsive medical patient, your partner asks you when he should obtain vitals. What would you tell him?
After the rapid secondary assessment
Which of the following is recognized as one of the four main components or phases of patient assessment?
During the assessment of the vital signs during the secondary assessment, for which assessment parameter will the EMT typically use a stethoscope?
You are dispatched to a residence for a 34-year-old male patient complaining of severe abdominal pain for the past two hours. On arrival, the patient tells you he would rate the pain as a 9 on a 1 to 10 scale. What part of the OPQRST would this information apply to?
What is typically done during the scene size-up?
Taking appropriate body substance isolation (BSI) precautions
The EMT has completed the assessment of the airway and breathing components of the primary assessment. During the assessment of the circulatory system, which finding would be managed immediately?
External arterial bleeding
Which of the following can indicate that the EMT should conduct a full secondary assessment rather than a modified secondary assessment in a patient with no significant mechanism of injury?
More injuries exist than the patient complains of.
You are called to a scene for an unresponsive patient. As you approach the patient, it appears he is in cardiac arrest. Given this assumption, what assessment parameter should you determine FIRST?
Which of the following statements is TRUE regarding the rapid secondary assessment?
Any critical finding identified in the primary assessment makes the patient unstable and a candidate for a rapid secondary assessment.
Forming your general impression of the patient can essentially be characterized as:
your view from the door before you start your physical exam.
If the patient has been injured, the EMT should first attempt to determine the:
The range of a normal respiratory rate for an adult patient is between:
While conducting reassessments of your unresponsive medical patient, which of the following merits MOST of your attention?
You have established manual in-line C-spine stabilization of an unconscious trauma patient. You may release manual stabilization:
when immobilization has been completed with straps and the CID.
When assessing the chest, where should the EMT listen to breath sounds at bilaterally?
Just below the second rib at the midclavicular line and just below the fourth rib at the midaxillary line.
It is important to form a general impression of every patient you care for, as it provides valuable information about the patient's condition. Forming a general impression includes:
A.
Obtaining the patients chief compliant
Your 64-year-old patient is complaining of chest pain radiating to his left jaw. What part of the OPQRST would this information apply to?
Which of the following is LEAST directly related to checking the effectiveness of interventions you have performed on a trauma patient?
Obtaining a blood pressure and pulse rate
How often should a reassessment be performed on a patient who presents stable?
If during your primary assessment, you note blood or secretions in the mouth and the patient is gurgling, what should you do NEXT?
Immediately Immediately suction the airway and clear any secretions.
Which of the following terms means closed or blocked?
Which of the following BEST describes establishing manual in-line stabilization?
Bringing the patient's head into a neutral in-line position and holding it there.
Once the scene is safe and controlled, you prepare to begin the primary assessment of the patient. Which of the following is TRUE regarding the primary assessment?
Critical conditions identified during the primary assessment must be treated immediately as found.
The FIRST step in the primary assessment of the patient involves
Forming the general impression
Why may the EMT have to change the general impression of the patient on the basis of information learned during the primary or secondary assessment?
An intoxicated patient may present as a medical patient but actually also have a traumatic injury.
You are called to a scene for an unresponsive patient. As you approach the patient, it appears he is in cardiac arrest. Given this assumption, what assessment parameter should you determine FIRST?
Which of the following abnormal airway sounds, if present in an unresponsive patient, would be considered a critical finding?
When determining the mental status during the primary assessment, what is typically determined FIRST in the patient?
During reassessment of your responsive medical patient, AVPU would refer to assessment of what patient parameter?
Which of the following clinical findings is consistent with a patient who is struggling to breathe?
Excessive abdominal muscle use.
At what point would the EMT consider the administration of oxygen to a patient with abdominal pain?
If the pulse ox dropped below 94 percent
You are assessing a 21-year-old female who is complaining of sharp and severe chest pain and shortness of breath. She states it started during her daily five-mile run. Her vitals are respirations of 32, pulse of 126, and blood pressure of 106/72 with an SPO2 of 94 percent. What is her treatment priority?
Your patient was injured in a construction accident and is complaining of pain to the pelvic region. Upon inspection, you note gross deformities to the pelvis. How should you continue to assess the pelvis?
Do not palpate the pelvis.
Which of the following is not part of the neurological assessment that the EMT would perform during the body systems approach?
Ask the patient about had any bowel or bladder changes.
For the mnemonic OPQRST, what is indicted by the "O" in relation to the medical patient?
Your patient was struck in the head by a golf ball while watching a golfing event. The patient experienced NO loss of consciousness. His airway is patent, breathing is regular, and the peripheral pulse is absent. The patient keeps asking you "What happened?" repeatedly. Given this, what would be your priority status determination?
What is the order in which you should perform a secondary assessment for a stable trauma patient who is responsive?
Modified secondary assessment, baseline vitals, history
While conducting reassessments of your unresponsive medical patient, which of the following merits MOST of your attention?
What is the purpose of repeating the assessment of your patient's chief complaint during the reassessment phase?
To determine the effectiveness of your treatment plan
Which of the following BEST outlines the sequences for completing the reassessment phase by the EMT while en route to the hospital?
Repeat the primary assessment, reassess the vitals, repeat the secondary assessment, assess effectiveness of interventions, and note trends in the patient's condition.
While obtaining the baseline vitals during the secondary assessment, the EMT will assess the respirations. What would be included about the respirations during the baseline vitals assessment?
Rate, tidal volume, and pulse ox reading
When assessing a patient using the major body systems approach, which body system is typically not included in the assessment?
Which of the following assessment findings would be considered a critical finding in an unresponsive medical patient?
A respiratory rate that is too slow is called:
During your secondary assessment of a patient who was injured while skiing, you remove her snow pants and find a puncture wound that is bleeding heavily. What critical intervention should you perform immediately?
Direct Pressure on the bleed
Which of the following conditions would cause the EMT to perform a head-to-toe secondary assessment when the patient has a non-significant mechanism of injury?
A sudden decline in the patient's mental status
You are treating a patient whose hand and arm were entrapped in a piece of equipment, causing a crushing injury. The patient's coworkers extricated him before your arrival, and there was no associated fall, unresponsiveness, or trauma elsewhere in the body. What type of immobilization will this patient likely receive?
Immobilization to the arm and hand
Which of the following steps is not part of the scene size-up?
Opening the airway of a patient who is in cardiac arrest
While assessing a patient with non-traumatic chest pain that is not cardiac in nature, when should the EMT perform the focused physical exam?
After obtaining the patient history
Which of the following is considered to be a critical finding of the neck in your unresponsive medical patient?
While on scene with a trauma patient, your EMT partner asks you whether she should request ALS backup. The presence of what clinical finding would cause you to have your partner summon ALS?
You are conducting a primary assessment on a patient who has suffered an emergency. Although the patient is not spontaneously conscious, you note that when you call his name loudly he will open his eyes and then respond. Given this, you determine that his mental status is:
When conducting the secondary assessment on a trauma patient whose upper body was under a car that fell on him, you should check the chest for superficial wounds, punctures, and:
Of the patients listed which would you consider to be most unstable?
An unconscious 29-year-old female who has very shallow breathing
An airway that is open can also be called:
You are conducting the primary assessment of a 52-year-old male who was in a car crash. When checking the airway, breathing, and circulation, you are looking for:
immediate threats to life.
When assessing the patient, paying attention to his mood, speech, posture, and motor activity would be MOST relevant to which body system?
A patient is breathing 24 times a minute with shallow chest wall motion and absent alveolar breath sounds. The pulse ox reads 94 percent, and the nail beds are ashen. Which of these findings most clearly indicates inadequate breathing?
Absent alveolar breath sounds
Which of the following is TRUE regarding crowing and stridor?
Both are commonly associated with swelling of the airway.
If the EMT is preparing to assess the characteristics of the skin, what location is the LEAST reliable location to use?
At the base of the nail beds of the hands
The mnemonic used to assess a patient's mental status is:
In performing a secondary assessment on a trauma patient for whom no critical findings were identified in the primary assessment, in what order should the EMT complete the steps?
Modified secondary assessment, baseline vital signs, history
Which of the following is NOT a reason to perform a reassessment of the patient?
Your transport time to the hospital is less than 10 minutes
What component of the body system approach in the secondary assessment would be most important on a patient who fell from a ladder as he tried to clean out the gutters of his home?
You arrive on scene and find an elderly female patient at the bottom of a flight of stairs leading to the basement of the home. The patient was found there by a family member. Given this information, what should you initially assume during the general impression?
That the patient is injured
What is the purpose of computing the Revised Trauma Score?
It is a numerical way to identify the severity of trauma.
Which of the following patients would receive a modified secondary assessment rather than a rapid secondary assessment?
A patient with a laceration to the finger
What is the critical intervention that must be provided to a patient who suddenly went unresponsive and has no palpable carotid pulse during the secondary assessment?
During the primary assessment, you should be looking for conditions that require immediate management as found. These may include:
open wounds to the chest that may disrupt thoracic pressures
During your ride-along time as an EMT student, you are called for a female patient with a severe headache that occurred suddenly and now radiates into her neck and jaw. She said that this occurred after she fell backwards and struck her head on the ground about 2 hours ago. Learning that the pain started 2 hours ago would be what part of the OPQRST history?
Which of the following is most likely to produce critical injuries in an adult patient?
A.
Partial ejection from a vehicle that was involved in an automobile crash
During reassessment, you determine that your stable cardiac patient has suddenly begun to deteriorate rapidly. In addition to evaluating your treatment plan, you may also wish to:
increase your transport priority.
Tracheal deviation found during the general impression or primary examination may indicate a/an:
When discussing the reassessment phase, the EMT would likely say that it:
is performed continuously, until arrival at the hospital.
When you report to your partner that the patient is a 46-year-old conscious male patient with leg pain, you have determined the:
What is the final component that is performed in completing the secondary assessment of a medical patient who is alert and oriented and complaining of non-traumatic chest pain?
You have been called to the scene of an MVC where a single occupant was ejected from the car. As you approach her, you note that her leg is grotesquely angulated, there is blood on her face, and you see a mix of blood and vomit bubbling from her mouth. As you perform manual cervical immobilization, the patient does NOT open her eyes. Given the findings thus far, what is her immediate life threat that should be managed during the primary assessment?
You are assessing a 35-year-old female patient who fell and struck her head while skiing. She is confused about the day of the week, and she does not remember falling, although a witness says that she collided with a tree. She was wearing a helmet at the time, according to bystanders. On the basis of what you know already, what is her priority?
Cool skin that is moist is referred to as cool and clammy. It is often related to:
blood loss or decreased perfusion.
You are at the scene of a patient with a significant mechanism of injury. After you complete your primary assessment, you find that the patient responds to painful stimuli with decorticate posturing. You also note blood in the hypopharynx, unequal chest wall motion, and a penetration injury to the leg with moderate bleeding. According to these findings, what would be your transport decision?
When assessing scene safety, the FIRST priority is:
The pulse oximeter is failing to read properly, and the patient is complaining of dyspnea, abdominal pain, and nausea and is becoming more and more anxious. What should the EMT do?
Administer high-concentration oxygen.
Which of the following steps will the EMT NOT include in the secondary assessment of a patient with a traumatic injury?
You are assessing a 25-year-old male who was struck in the head by a piece of heavy metal while at work and had a brief moment of unresponsiveness. Upon your arrival, the patient is conscious and complaining of a headache. Which body system, at a minimum, would it be necessary to examine during your secondary assessment?
Which of the following findings is MOST indicative of inadequate breathing in your patient?
Absent alveolar breath sounds
During what part of the SAMPLE assessment would the EMT learn that the patient has severe abdominal pain?
You are conducting the secondary assessment on a trauma patient who has fallen off a ladder onto a concrete floor. When assessing the pelvis of this patient, you should determine the presence or absence of wounds, deformities, and:
While performing a rapid secondary assessment, why should the EMT NOT focus solely on the complaints the patient has?
The pain the patient is experiencing may not correlate with the most critical injury.
What is the highest numerical value that is assigned to eye opening when computing the GCS?
Which of the following assessment findings would be considered critical during the primary assessment?