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| Section | Weight | Objectives |
|---|---|---|
| EMS Operations | 10–14% | - Documentation and legal aspects - EMS system roles and responsibilities - Emergency vehicle operations and safety - Incident command and multiple-casualty situations |
| Secondary Assessment | 5–9% | - Symptom assessment and history taking - Focused history and physical exam - Vital signs and monitoring |
| Primary Assessment | 39–43% | - Identification and management of life-threatening conditions - Initial patient assessment - General patient impression and priority determination - Airway, breathing, and circulation management |
| Scene Size-Up and Safety | 15–19% | - Mechanism of injury / nature of illness - Hazard recognition and management - Scene assessment and safety protocols |
| Patient Treatment and Transport | 20–24% | - Medical and trauma care interventions - Medication administration and protocols - Communication with receiving facilities - Patient packaging and transport procedures |
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NEW QUESTION # 68
A patient is experiencing acute coronary syndrome but is not hypoxemic. Which of the following results could come from oxygen administration? Select the two answer options that are correct.
Answer: C,E
Explanation:
The correct answers are C. Increased tissue damage and E. Coronary artery vasoconstriction.
In patients with acute coronary syndrome (ACS) who are NOT hypoxemic, routine oxygen administration is no longer recommended because it may actually be harmful.
Key pathophysiology:
1. Coronary Artery Vasoconstriction (E):
High concentrations of oxygen can cause vasoconstriction of coronary arteries, which reduces blood flow to already ischemic heart tissue.
"Supplemental oxygen in non-hypoxemic patients may cause coronary vasoconstriction."
2. Increased Tissue Damage (C):
Excess oxygen can lead to oxidative stress and worsen ischemic injury, potentially increasing infarct size or tissue damage.
"Hyperoxia may increase oxidative injury and worsen myocardial damage." Why the other options are incorrect:
A). Reduced mortality: Evidence does not support mortality benefit in non-hypoxemic ACS patients.
B). Resolution of chest pain: Oxygen does not reliably relieve ischemic chest pain unless hypoxia is present.
D). Reduction in infarction size: Studies show no benefit and possible harm.
NREMT/AHA-aligned guidance emphasizes:
"Administer oxygen only if SpO# is less than 94% or if the patient is hypoxic." Routine oxygen in normoxic patients is not recommended and may be harmful.
Exact Extracts (NREMT/AHA-aligned references):
"Avoid routine oxygen use in patients with normal oxygen saturation."
"Hyperoxia can cause coronary vasoconstriction."
"Excess oxygen may worsen myocardial injury."
Clinical Priority Summary:
In non-hypoxemic ACS patients, oxygen can cause harm rather than benefit, specifically vasoconstriction and increased tissue damage, making C and E correct.
References:
NREMT EMT Education Standards - Cardiology & Resuscitation
American Heart Association (AHA) Guidelines for CPR and ECC
NREMT National Continued Competency Program (NCCP)
NEW QUESTION # 69
Which of the following techniques are appropriate for examining a patient with an acute abdomen? Select the two correct options.
Answer: B,C
Explanation:
In patients with acute abdominal pain, you must first inspect (visualize) for distension, discoloration, or masses before touching. Palpation always begins away from the most painful area. The patient should be in a supine position with knees flexed to relax the abdominal muscles and ease the exam.
Palpating a pulsating mass could rupture an abdominal aortic aneurysm and is contraindicated.
References:
NREMT Cognitive Exam Blueprint - Medical Emergencies
Emergency Care and Transportation of the Sick and Injured (AAOS, 11th ed.) - Chapter: Abdominal and GI Emergencies EMT-B National Standard Curriculum, Module: Medical Emergencies
NEW QUESTION # 70
A choking patient becomes unresponsive. What should the EMT perform next? Select the two correct options.
Answer: A,E
Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
If a choking patient becomes unresponsive, EMTs should:
* Check for a pulse
* Begin chest compressions if no pulse is foundChest compressions can help dislodge 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
NEW QUESTION # 71
An EMT is using a BVM to ventilate a 28-year-old patient with asthma. The patient is unresponsive, and their vital signs are BP 70/40, P 142, R 8, and SpO2 89% on room air. The patient is becoming increasingly difficult to ventilate. What should the EMT do next?
Answer: A
Explanation:
In patients with asthma experiencing respiratory failure, improper ventilation (especially excessive rates) can lead to air trapping and increased intrathoracic pressure, reducing venous return and worsening hypotension.
The correct technique is to ventilate slowly to allow full exhalation - around 1 breath every 5-6 seconds for adults.
CPAP is contraindicated in unresponsive patients who cannot maintain their own airway. A non-rebreather mask would be insufficient for an unresponsive patient, and forceful ventilation risks barotrauma.
References:
NREMT EMT Psychomotor Exam Guide: Airway, Respiration and Ventilation
American Heart Association (AHA) BLS Provider Manual (2020)
National EMS Education Standards (2011) - Airway Management Section
NEW QUESTION # 72
Which of the following signs and symptoms indicate dehydration in an infant? Select the three correct options.
Answer: A,B,C
Explanation:
Dehydration signs in infants include:
* Poor skin turgor (elasticity)
* Sunken fontanelles (indicative of fluid loss)
* Delayed capillary refill ( > 2 seconds)
Flushed skin is more common in fever or heat illness, not dehydration. Hypotension, not hypertension, is associated with dehydration in late stages.
References:
NREMT Pediatric Assessment and Fluid Emergencies
PALS Provider Manual - Dehydration in Infants
AAOS Emergency Care (11th ed.) - Pediatric Emergency Chapter
NEW QUESTION # 73
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