CEP Medical Emergencies & Patient Transport 2 — Questions and Answers
Question 1: A patient presents with sudden-onset severe headache described as 'the worst of my life,' neck stiffness, and photophobia. Which condition should be your primary concern?
- Migraine with aura
- Subarachnoid hemorrhage (Correct answer)
- Tension headache
- Hypertensive urgency
Correct answer: Subarachnoid hemorrhage
A sudden 'thunderclap' headache with meningeal signs is the classic presentation of subarachnoid hemorrhage until proven otherwise.
Question 2: Which glucose level threshold generally requires paramedic intervention for symptomatic hypoglycemia in adults?
- Below 100 mg/dL
- Below 80 mg/dL
- Below 60 mg/dL (Correct answer)
- Below 40 mg/dL
Correct answer: Below 60 mg/dL
Symptomatic hypoglycemia typically occurs below 60 mg/dL and warrants dextrose administration or oral glucose.
Question 3: During patient transport, a STEMI patient becomes pulseless with ventricular fibrillation. What is the immediate priority?
- Continue transport to the cath lab without interruption
- Defibrillate as soon as possible (Correct answer)
- Administer amiodarone 300 mg IV
- Perform synchronized cardioversion
Correct answer: Defibrillate as soon as possible
VF is a shockable rhythm requiring immediate unsynchronized defibrillation before any pharmacological intervention.
Question 4: A 68-year-old diabetic male presents with diaphoresis, nausea, and jaw pain but denies chest pain. Which condition should top your differential?
- Peptic ulcer disease
- Acute myocardial infarction (Correct answer)
- Gastroesophageal reflux
- Anxiety attack
Correct answer: Acute myocardial infarction
Diabetic patients often present with atypical AMI symptoms such as jaw pain, nausea, and diaphoresis without classic chest pain.
Question 5: Which position is recommended for transporting an unresponsive patient without suspected spinal injury who is breathing adequately?
- Supine with legs elevated
- Recovery (lateral recumbent) position (Correct answer)
- Prone position
- Fowler's position at 45 degrees
Correct answer: Recovery (lateral recumbent) position
The recovery position protects the airway from aspiration in unresponsive breathing patients without spinal precautions.
Question 6: A patient with known COPD is in severe respiratory distress with SpO2 of 82%. What is the correct oxygen delivery approach?
- Withhold oxygen to avoid hypoxic drive suppression
- Apply 100% NRB mask immediately
- Titrate oxygen to achieve SpO2 88–92% (Correct answer)
- Administer oxygen only if SpO2 drops below 70%
Correct 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.
Question 7: Which transport decision is most appropriate for a patient with suspected large vessel occlusion (LVO) stroke?
- Transport to the nearest ED regardless of capability
- Bypass nearest ED and transport to a comprehensive stroke center (Correct answer)
- Transport to nearest ED for tPA, then transfer
- Delay transport to complete full neurological assessment on scene
Correct answer: Bypass nearest ED and transport to a comprehensive stroke center
LVO strokes require mechanical thrombectomy, available only at comprehensive stroke centers, making direct transport the preferred approach.
CEP Medical Emergencies & Patient Transport 2
A patient presents with sudden-onset severe headache described as 'the worst of my life,' neck stiffness, and photophobia.
Which condition should be your primary concern?