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| Section | Objectives |
|---|---|
| Topic 1: Cardiology and Resuscitation | - Cardiac Emergencies
|
| Topic 2: EMS Operations | - Operational Procedures
|
| Topic 3: Trauma | - Trauma Assessment and Care
|
| Topic 4: Medical, Obstetrics and Gynecology | - Medical Emergencies
|
| Topic 5: Airway, Respiration and Ventilation | - Airway Management
|
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問題 #206
A 74-year-old patient has epigastric pain without relief from three doses of prescribed nitroglycerin. The patient is anxious, nauseated, and diaphoretic. The vital signs are BP 180/90 mmHg, P 62/min, R 20/min and shallow, and SpO# 92% on room air. What actions should the EMT prioritize for this patient? Select the two answer options that are correct.
答案：C,E
解題說明：
This patient's presentation is highly suspicious for acute coronary syndrome (ACS). NREMT education emphasizes that epigastric pain, especially in elderly patients, may represent myocardial ischemia. The lack of relief after three doses of nitroglycerin further increases concern for an evolving myocardial infarction.
Option A (Give aspirin) is correct because aspirin inhibits platelet aggregation and is a cornerstone of early ACS management. NREMT guidelines recommend administering aspirin as soon as possible unless contraindications exist.
Option B (Apply oxygen) is correct because the patient's oxygen saturation is 92%, which is below normal.
NREMT recommends supplemental oxygen for patients with suspected cardiac ischemia who are hypoxic or in respiratory distress.
Option C may provide comfort but does not address the underlying ischemia.
Option D is incorrect because the patient has already taken the maximum recommended prehospital doses of nitroglycerin.
Option E is outside the EMT scope of practice in many systems and is not a priority EMT intervention.
NREMT emphasizes early aspirin administration, oxygenation, continuous monitoring, and rapid transport for suspected ACS.
問題 #207
A choking patient becomes unresponsive. What should the EMT perform next? Select the two correct options.
答案：C,E
解題說明：
Comprehensive and Detailed Explanation From Exact Extract:
If achoking patient becomes unresponsive, EMTs should:
* Check for a pulse
* Begin chest compressionsif no pulse is foundChest compressions can helpdislodge the object. After compressions, the airway should be opened and inspected. Back blows are not appropriate for unconscious patients.
Ventilation is attempted after clearing the airway or if no object is seen.Do not withhold compressions waiting for object removal.
References:
AHA BLS Provider Manual (2020) - Foreign Body Airway Obstruction Algorithm NREMT Airway Skills Sheet - Obstructed Airway National EMS Education Standards - Respiratory and Airway Management
問題 #208
An 86-year-old patient involved in a motor vehicle collision struck a knee on the dashboard. What injuries are most associated with the knee impacting the dashboard? Select the two answer options that are correct.
答案：A,D
解題說明：
The correct answers are B. Femur fracture and E. Posterior hip dislocation.
This mechanism is classically known as a "dashboard injury", where the knee strikes the dashboard during a motor vehicle collision. The force is transmitted along the femur toward the hip.
Why B is correct (Femur fracture):
The force applied to the knee travels up the femur, which can result in:
* Femoral shaft fractures
* Significant internal bleeding
NREMT trauma guidance states:
* "High-energy impacts to the lower extremities can result in femur fractures." Why E is correct (Posterior hip dislocation):
Dashboard injuries commonly cause:
* Posterior displacement of the femoral head from the acetabulum
* This occurs when the femur is driven backward while the hip is flexed NREMT-aligned content:
* "A blow to the knee in a seated position can result in posterior hip dislocation." Why the other options are incorrect:
* A. Tibia fracture: More commonly associated with direct lower leg trauma, not classic dashboard mechanism.
* C. Ruptured peritoneum: Not a typical injury from this mechanism.
* D. Rupture of the bladder: More associated with pelvic fractures, not isolated dashboard knee impact.
Exact Extracts:
* "A dashboard injury can transmit force up the femur causing hip dislocation."
* "Posterior hip dislocation is commonly associated with knee impact in MVCs."
* "Femur fractures are common in high-energy trauma."
References:
NREMT EMT Education Standards - Trauma (Musculoskeletal Injuries)
NREMT National Continued Competency Program (NCCP) - Trauma Emergencies Prehospital Emergency Care (EMT) - Mechanisms of Injury and Trauma Assessment
問題 #209
A 5-year-old patient was stung by a bee and has urticaria and dyspnea. Wheezing is auscultated. What medication and dose should the EMT administer first?
答案：D
解題說明：
**
This patient has signs of anaphylaxis , not just a mild allergic reaction: bee sting exposure , urticaria , dyspnea , and wheezing . In NREMT-aligned EMT education, epinephrine is the first-line treatment for anaphylaxis because it treats the life-threatening airway and breathing problem by bronchodilation and also helps reverse vasodilation and capillary leak.
For EMT-level medication guidance, the national EMT refresher curriculum specifically lists epinephrine auto-injector dosing as: adult = 0.3 mg and infant/child = 0.15 mg . Since the patient is 5 years old , the correct pediatric dose is 0.15 mg , making D the correct answer.
The albuterol options are not the best first answer here. Albuterol may help wheezing from bronchospasm, but in anaphylaxis the priority medication is epinephrine first , because the problem is a systemic allergic reaction that can rapidly worsen and affect the airway and circulation. NREMT education guidance explicitly emphasizes epinephrine administration for anaphylaxis.
Why the other options are wrong:
A). Albuterol 0.5 mg - not the standard EMT answer here, and not first-line for anaphylaxis.
B). Albuterol 2.5 mg - this is a common nebulized albuterol dose, but it is still not the first medication for anaphylaxis.
C). Epinephrine 0.3 mg - this is the adult auto-injector dose, not the usual pediatric dose listed in EMT national curriculum materials.
D). Epinephrine 0.15 mg - correct pediatric first-line treatment.
問題 #210
A 67-year-old patient reports crushing chest pressure. The vital signs are BP 156/98, P 64, R 14, and SpO2 94%. What treatments should the EMT provide first? Select the two correct options.
答案：B,C
解題說明：
Comprehensive and Detailed Explanation From Exact Extract:
The patient's symptoms are consistent withacute coronary syndrome (ACS). Thefirst-line treatmentsare:
* Aspirin(160-325 mg): inhibits platelet aggregation, reducing clot progression.
* Oxygen: administered when SpO# <94% or signs of hypoxia/distress are present.
CPAPis for pulmonary edema or respiratory failure.Nitroglycerinrequires BP >90 systolic and medical direction approval. Laying the patient supine may increase myocardial workload and is inappropriate unless hypotension occurs.
References:
NREMT Cardiology and Resuscitation Guidelines
AHA ACLS Provider Manual (2020) - Acute Coronary Syndrome Treatment
National EMS Education Standards - Cardiovascular Emergencies
問題 #211
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EMT考試證照綜述: https://www.vcesoft.com/EMT-pdf.html
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