AEMCA AEMCA - Advanced Emergency Medical Care Assistant Musculoskeletal and Environmental Emergencies Questions and Answers 1 — Questions and Answers
Question 1: A patient rescued from a house fire presents with hot, dry skin; temperature 41°C (106°F); altered mental status; and no sweating. What condition is this?
- Heat exhaustion
- Heat cramps
- Classic heat stroke (Correct answer)
- Exertional heat stroke
Correct answer: Classic heat stroke
Classic heat stroke is characterized by hyperthermia >40°C, anhidrosis, and CNS dysfunction, typically in elderly or sedentary individuals.
Question 2: What is the preferred prehospital cooling method for a patient with heat stroke?
- Oral hydration with cold water
- Cold-water immersion or evaporative cooling with fanning (Correct answer)
- Ice packs to the groin only
- Antipyretics such as acetaminophen
Correct answer: Cold-water immersion or evaporative cooling with fanning
Cold-water immersion or evaporative cooling with fanning achieves the fastest core temperature reduction in heat stroke patients.
Question 3: Which electrolyte abnormality is most associated with severe rhabdomyolysis following crush injury?
- Hyponatremia
- Hypocalcemia
- Hyperkalemia (Correct answer)
- Hypomagnesemia
Correct answer: Hyperkalemia
Rhabdomyolysis releases intracellular potassium from damaged muscle cells, causing life-threatening hyperkalemia.
Question 4: A 30-year-old hiker presents with confusion, ataxia, and slurred speech after several days in the cold. Core temperature is 30°C (86°F). What dysrhythmia is classically associated with this temperature?
- Ventricular fibrillation
- Osborn (J) waves on ECG with risk of VF (Correct answer)
- Third-degree heart block
- Atrial flutter
Correct answer: Osborn (J) waves on ECG with risk of VF
Hypothermia at this level produces Osborn (J) waves on ECG and significantly increases the risk of ventricular fibrillation.
Question 5: When should CPR be withheld in a hypothermic cardiac arrest patient in the prehospital setting?
- Core temperature below 30°C
- Patient appears frozen with no signs of life
- Obvious lethal injury or the chest wall is non-compressible (frozen solid) (Correct answer)
- Asystole on the monitor
Correct answer: Obvious lethal injury or the chest wall is non-compressible (frozen solid)
CPR should be withheld only when an obvious lethal injury is present or the chest wall cannot be compressed due to freezing.
Question 6: What is the correct prehospital management priority for a patient with a closed femur fracture?
- Immediate surgical consultation by phone
- Traction splint application and IV access for fluid resuscitation (Correct answer)
- Apply a tourniquet proximal to the fracture
- Ice packs and elevation alone
Correct answer: Traction splint application and IV access for fluid resuscitation
Closed femur fractures can cause 1–2 liters of blood loss into the thigh; traction splinting stabilizes the fracture and IV access allows fluid replacement.
AEMCA AEMCA - Advanced Emergency Medical Care Assistant Musculoskeletal and Environmental Emergencies Questions and Answers 1
A patient rescued from a house fire presents with hot, dry skin; temperature 41°C (106°F); altered mental status; and no sweating.
What condition is this?