AEMCA AEMCA - Advanced Emergency Medical Care Assistant Musculoskeletal and Environmental Emergencies Questions and Answers 2 — Questions and Answers
Question 1: A patient in a lightning strike has cardiopulmonary arrest. In a mass casualty scenario involving multiple lightning strike victims, who is prioritized for CPR?
- Patients who are breathing and conscious
- Patients in cardiopulmonary arrest (reverse triage) (Correct answer)
- Oldest patients first
- Patients with the most burns
Correct answer: Patients in cardiopulmonary arrest (reverse triage)
Lightning strike victims in cardiac arrest have a high survival rate with CPR; reverse triage prioritizes the apparently dead because they are salvageable.
Question 2: Which sign indicates compartment syndrome in an injured extremity?
- Crepitus on palpation
- Pain with passive stretch of muscles in the affected compartment (Correct answer)
- Ecchymosis overlying the fracture site
- Weak but palpable distal pulse
Correct answer: Pain with passive stretch of muscles in the affected compartment
Pain out of proportion with passive stretch of muscles in the compartment is the earliest and most sensitive sign of compartment syndrome.
Question 3: A construction worker is trapped under debris for 2 hours. During extrication, what phenomenon can occur that may cause sudden cardiac arrest?
- Tension pneumothorax
- Crush syndrome with potassium release causing dysrhythmia (Correct answer)
- Air embolism
- Aortic rupture
Correct answer: Crush syndrome with potassium release causing dysrhythmia
Release of a crush injury frees myoglobin, potassium, and lactic acid into circulation (reperfusion), potentially triggering fatal dysrhythmias.
Question 4: At what altitude does acute mountain sickness (AMS) typically begin to manifest?
- 500–1,000 meters (1,640–3,281 ft)
- Above 2,500 meters (8,200 ft) (Correct answer)
- Above 1,000 meters (3,281 ft)
- Only above 5,000 meters (16,404 ft)
Correct answer: Above 2,500 meters (8,200 ft)
AMS typically begins to manifest above 2,500 meters, where partial pressure of oxygen becomes significantly reduced.
Question 5: A scuba diver surfaces rapidly and complains of joint pain, rash, and dyspnea. What condition should be suspected?
- Arterial gas embolism
- Decompression sickness (the bends) (Correct answer)
- Nitrogen narcosis
- Pulmonary barotrauma
Correct answer: Decompression sickness (the bends)
Decompression sickness results from dissolved nitrogen forming bubbles in tissues and blood during rapid ascent, causing joint pain, rash, and respiratory symptoms.
Question 6: What is the prehospital treatment for a patient with severe decompression sickness?
- High-flow 100% oxygen and rapid transport to a hyperbaric facility (Correct answer)
- IV morphine and ice to affected joints
- Immediate recompression by returning to depth
- Aspirin and fluid restriction
Correct answer: High-flow 100% oxygen and rapid transport to a hyperbaric facility
100% oxygen accelerates nitrogen washout and reduces bubble size; hyperbaric oxygen therapy is definitive treatment for DCS.
AEMCA AEMCA - Advanced Emergency Medical Care Assistant Musculoskeletal and Environmental Emergencies Questions and Answers 2
A patient in a lightning strike has cardiopulmonary arrest.
In a mass casualty scenario involving multiple lightning strike victims, who is prioritized for CPR?