CEP Medical Emergencies & Patient Transport 4 — Questions and Answers
Question 1: A 45-year-old presents with acute confusion, fever of 104°F, and nuchal rigidity following a URI last week. Which transport priority is most appropriate?
- Non-urgent transport after administering antipyretics
- Urgent transport with IV access and fluid resuscitation (Correct answer)
- Scene stay for full neurological assessment
- Routine transport to the nearest urgent care
Correct answer: Urgent transport with IV access and fluid resuscitation
Bacterial meningitis is a life-threatening emergency requiring urgent transport with supportive IV access and fluid management en route.
Question 2: Which of the following is the correct algorithm for managing a patient with suspected opioid overdose who is unresponsive and apneic?
- Naloxone first, then ventilations if no response
- BVM ventilations first, then naloxone if available (Correct answer)
- Chest compressions first to circulate naloxone
- Wait for naloxone to work before initiating ventilations
Correct answer: BVM ventilations first, then naloxone if available
Airway management and ventilation take priority; naloxone reverses sedation but does not substitute for correcting hypoxia.
Question 3: During interfacility transport of a ventilated patient, the ventilator high-pressure alarm activates. What is the most likely cause?
- Disconnected circuit
- Kinked ETT or mucus plug (Correct answer)
- Low FiO2 setting
- Failure of the exhalation valve
Correct answer: Kinked ETT or mucus plug
High-pressure alarms during transport most commonly indicate airway obstruction from a kinked tube, mucus plug, or patient biting.
Question 4: A patient presents with altered mental status, temperature of 105.8°F, and anhidrosis after exercising in extreme heat. Which condition is most likely?
- Heat exhaustion
- Heat cramps
- Classic heat stroke
- Exertional heat stroke (Correct answer)
Correct answer: Exertional heat stroke
Exertional heat stroke occurs in physically active individuals with hyperthermia, altered mental status, and anhidrosis after exertion.
Question 5: A 72-year-old woman presents with altered mental status, urinary incontinence, and a rapid irregular pulse. Which condition should be considered beyond a cardiac arrhythmia?
- Stroke
- Urinary tract infection with sepsis (Correct answer)
- Alzheimer's exacerbation
- New-onset dementia
Correct answer: Urinary tract infection with sepsis
UTI-induced sepsis commonly presents atypically in elderly patients with confusion and incontinence, and the tachycardia may be sepsis-related.
Question 6: Which medication is contraindicated in a patient with suspected right ventricular infarction presenting with hypotension?
- Aspirin
- Nitroglycerin (Correct answer)
- Heparin
- Morphine sulfate for pain only
Correct answer: Nitroglycerin
Nitroglycerin causes venodilation that reduces preload, which is dangerous in RV infarction where the right ventricle depends on adequate preload.
Question 7: A patient is transported in a left lateral recumbent position during the third trimester of pregnancy. What is the primary reason for this position?
- To prevent nausea during transport
- To relieve aortocaval compression by the gravid uterus (Correct answer)
- To facilitate fetal descent in active labor
- To reduce risk of premature rupture of membranes
Correct answer: To relieve aortocaval compression by the gravid uterus
Left lateral positioning displaces the gravid uterus off the inferior vena cava and aorta, maintaining maternal venous return and cardiac output.
CEP Medical Emergencies & Patient Transport 4
A 45-year-old presents with acute confusion, fever of 104°F, and nuchal rigidity following a URI last week.
Which transport priority is most appropriate?