Mixed Deck — All CEP Topics Flashcards

What is the correct IO (intraosseous) site for a pediatric patient under 6 years old when IV access fails?

Answer: Proximal tibia, 2 cm below the tibial tuberosity

The proximal tibia, approximately 2 cm below the tibial tuberosity on the anteromedial surface, is the preferred IO site for children under 6.

What does the acronym METHANE stand for in MCI reporting?

Answer: Major incident, Exact location, Type, Hazards, Access, Number of casualties, Emergency services required

METHANE is the standardized MCI report format: Major incident declared, Exact location, Type of incident, Hazards, Access and egress, Number of casualties, Emergency services required.

Which of the following is the MOST reliable indicator of internal hemorrhage in a blunt abdominal trauma patient?

Answer: Decreasing blood pressure with tachycardia

Progressive hemodynamic instability (hypotension + tachycardia) is the most reliable field indicator of significant internal hemorrhage.

What is the CORRECT target systolic blood pressure during permissive hypotension for a penetrating torso trauma patient without TBI?

Answer: 80–90 mmHg

Permissive hypotension targets SBP 80–90 mmHg in penetrating torso trauma to limit clot disruption while maintaining minimal perfusion until surgical control.

Which finding during a secondary assessment MOST suggests a diaphragmatic rupture?

Answer: Bowel sounds auscultated in the chest

Auscultation of bowel sounds in the thoracic cavity indicates herniation of abdominal organs through a diaphragmatic tear.

A patient with known COPD is in severe respiratory distress with SpO2 of 82%. What is the correct oxygen delivery approach?

Answer: Titrate oxygen to achieve SpO2 88–92%

COPD patients should receive titrated oxygen targeting SpO2 88–92% to relieve hypoxemia without eliminating hypoxic drive.

A patient presents with abrupt onset of tearing back pain radiating to the abdomen, hypertension, and unequal blood pressures between arms. Which diagnosis is most likely?

Answer: Aortic dissection

Tearing or ripping pain with BP differential between extremities is the classic presentation of aortic dissection requiring emergent surgical evaluation.

What is the hallmark sign of a tension pneumothorax in a pediatric patient that distinguishes it from simple pneumothorax?

Answer: Tracheal deviation away from the affected side

Tracheal deviation away from the affected side occurs in tension pneumothorax due to mediastinal shift from increased intrapleural pressure.

Which pharmacologic agent is the first-line treatment for symptomatic bradycardia due to increased vagal tone?

Answer: Atropine

Atropine 0.5 mg IV is the first-line agent for symptomatic bradycardia caused by increased vagal tone, blocking muscarinic receptors to increase heart rate.

A patient with severe asthma is intubated. Ventilator peak airway pressures are 60 cmH2O and rising. Which ventilator adjustment is MOST appropriate?

Answer: Decrease respiratory rate and increase expiratory time

In obstructive disease, decreasing the respiratory rate and allowing more time for exhalation prevents auto-PEEP and reduces the risk of breath stacking and barotrauma.

A child is seizing and IV access cannot be established. Which route is preferred for benzodiazepine administration?

Answer: Intranasal or rectal

Intranasal or rectal benzodiazepine administration is preferred when IV access is unavailable for pediatric seizures in the prehospital setting.

During endotracheal intubation of a trauma patient, a right mainstem intubation is confirmed. Correct action is to:

Answer: Deflate the cuff, withdraw tube 2–3 cm, re-inflate, and reconfirm

Withdrawing the ETT 2–3 cm above the carina and reconfirming placement corrects right mainstem intubation without removing the secured airway.

A patient is taking sildenafil and presents with chest pain. Which medication must be withheld?

Answer: Nitroglycerin

Nitroglycerin is absolutely contraindicated within 24-48 hours of phosphodiesterase-5 inhibitor (e.g., sildenafil) use due to the risk of severe, refractory hypotension.

A patient in cardiogenic shock has a BP of 70/50 and is in sinus rhythm at 100 bpm. Which vasopressor is most appropriate as initial therapy?

Answer: Norepinephrine infusion starting at 0.1 mcg/kg/min

Norepinephrine is the preferred vasopressor for cardiogenic shock due to its combined alpha-1 vasoconstriction and mild beta-1 inotropic support with less tachycardia than dopamine.

What is the PRIMARY reason for regulatory compliance in the Certified Emergency Paramedic profession?

Answer: To protect public safety, ensure quality, and maintain professional integrity

Regulatory compliance protects public safety, ensures quality, and maintains professional integrity.

Which medication used in RSI is CONTRAINDICATED in a patient with a crush injury and suspected hyperkalemia?

Answer: Succinylcholine

Succinylcholine causes potassium efflux from muscle cells and is contraindicated in hyperkalemia, crush injuries, burns >24 hours, denervation injuries, and prolonged immobilization.

Which of the following BEST describes the 'platinum ten minutes' concept in trauma care?

Answer: Total prehospital time goal before transport for critical trauma patients

The platinum ten minutes refers to limiting total on-scene time to under 10 minutes for critical trauma patients to minimize time to definitive surgical care.

During a 12-lead ECG interpretation, ST elevation in leads V1-V4 with reciprocal depression in II, III, aVF indicates:

Answer: Anterior wall STEMI

ST elevation in V1-V4 indicates anterior wall STEMI, typically involving the left anterior descending artery territory.

When assessment results for a Certified Emergency Paramedic evaluation are inconclusive, the BEST practice is to:

Answer: Conduct additional assessment using alternative methods

Inconclusive results require additional assessment using alternative methods for triangulation.

Which position is recommended for transporting an unresponsive patient without suspected spinal injury who is breathing adequately?

Answer: Recovery (lateral recumbent) position

The recovery position protects the airway from aspiration in unresponsive breathing patients without spinal precautions.