EMD - Emergency Medical Dispatch Cardiovascular & Respiratory Protocols Questions and Answers 1 — Questions and Answers
Question 1: A caller reports a 58-year-old male with a history of COPD is severely short of breath. According to the MPDS Breathing Problems Protocol (Protocol 6), which of the following Key Questions is most critical for identifying an immediate, high-priority life threat?
- Has he taken any medications for this?
- Is he changing color? (Correct answer)
- How long has this been going on?
- Does he have a fever?
Correct answer: Is he changing color?
The question 'Is he changing color?' is designed to identify cyanosis (a blue or gray skin color), which is a critical sign of severe hypoxia (lack of oxygen) and represents an immediate life threat requiring the highest priority dispatch. While other questions are important, identifying cyanosis is paramount for determining the most severe patients on this protocol.
Question 2: An EMD is handling a call for a 9-year-old child who is choking on food. The caller states the child is awake, coughing forcefully, and able to whisper. Based on the MPDS Choking Protocol (Protocol 11), what is the most appropriate Pre-Arrival Instruction?
- Immediately begin abdominal thrusts (the Heimlich maneuver).
- Lay the child on their back and start chest compressions.
- Encourage the child to continue coughing. (Correct answer)
- Perform five back blows between the shoulder blades.
Correct answer: Encourage the child to continue coughing.
For a patient with a partial airway obstruction who is still able to move air effectively (indicated by forceful coughing and the ability to make noise), the recommended instruction is to encourage them to continue coughing to expel the object on their own. Interventions like the Heimlich maneuver are reserved for complete airway obstructions where the patient cannot cough, speak, or breathe.
Question 3: A caller reports that a 45-year-old collapsed and is now making 'gasping' or 'snoring' sounds. How should the EMD interpret these sounds according to cardiac and respiratory arrest protocols?
- As a sign the patient is starting to wake up.
- As effective, although noisy, breathing.
- As normal breathing for an unconscious person.
- As agonal respirations, treating the event as a cardiac arrest. (Correct answer)
Correct answer: As agonal respirations, treating the event as a cardiac arrest.
Gasping, gurgling, or snoring-like sounds after a sudden collapse are known as agonal respirations. They are a sign of a brainstem reflex in the setting of cardiac arrest and are not effective breathing. EMDs are trained to recognize these descriptions as signs of cardiac arrest and should immediately proceed with the Cardiac/Respiratory Arrest Protocol (Protocol 9), including CPR instructions.
Question 4: While using the Chest Pain Protocol (Protocol 10), the EMD is preparing to give instructions for aspirin administration. Which of the following patient statements represents a definitive contraindication for this instruction?
- "I took my daily blood pressure medicine this morning."
- "The pain is really sharp, right in the center of my chest."
- "I'm allergic to Ibuprofen and other NSAIDs." (Correct answer)
- "I have a history of heartburn after I eat spicy food."
Correct answer: "I'm allergic to Ibuprofen and other NSAIDs."
A known allergy or hypersensitivity to aspirin or other NSAIDs is an absolute contraindication to its administration. Providing aspirin to an allergic patient could cause a severe anaphylactic reaction, compounding the existing medical emergency. The other statements do not represent absolute contraindications in the EMD setting.
Question 5: When providing CPR instructions for an adult in cardiac arrest, what is the first physical action the EMD should instruct a layperson caller to perform after ensuring the patient is on their back on a hard surface?
- Give two slow rescue breaths.
- Check for a carotid pulse for at least 15 seconds.
- Place the heel of one hand in the center of the chest and push hard. (Correct answer)
- Slightly elevate the patient's legs to improve blood flow.
Correct answer: Place the heel of one hand in the center of the chest and push hard.
Current AHA and IAED guidelines emphasize a compressions-first approach to CPR for adult cardiac arrest. The first and most critical step is to begin circulating blood by starting high-quality chest compressions. The instruction should be simple and direct: place the heel of the hand on the center of the chest, place the other hand on top, and begin pushing hard and fast.
Question 6: Within the MPDS Chest Pain Protocol (Protocol 10), what is the primary purpose of asking if the pain is described as 'sharp' or gets worse with a deep breath?
- To confirm the patient is having a heart attack.
- To help differentiate cardiac pain from pleuritic or musculoskeletal pain. (Correct answer)
- To determine if the patient has a history of asthma.
- To decide if the patient needs oxygen immediately.
Correct answer: To help differentiate cardiac pain from pleuritic or musculoskeletal pain.
While not a diagnostic tool, this question helps differentiate the classic, pressure-like pain of a heart attack from other causes. Pleuritic pain (from inflammation of the lung lining) or musculoskeletal pain is often described as sharp and worsens with breathing or movement. This information helps build a clinical picture but does not rule out a cardiac cause.
EMD - Emergency Medical Dispatch Cardiovascular & Respiratory Protocols Questions and Answers 1
A caller reports a 58-year-old male with a history of COPD is severely short of breath.
According to the MPDS Breathing Problems Protocol (Protocol 6), which of the following Key Questions is most critical for identifying an immediate, high-priority life threat?