EMS Treatment Planning & Management 2 — Questions and Answers
Question 1: A 45-year-old male presents with crushing chest pain radiating to the left arm, diaphoresis, and nausea. Which treatment priority is MOST appropriate?
- Administer aspirin 324 mg and prepare for rapid transport (Correct answer)
- Apply ice packs to the chest and monitor vitals
- Administer nitroglycerin first, then contact medical direction
- Perform a 12-lead ECG and wait for results before any treatment
Correct answer: Administer aspirin 324 mg and prepare for rapid transport
Aspirin administration and rapid transport are first priorities for suspected AMI as early reperfusion therapy is time-sensitive.
Question 2: When managing a patient with suspected tension pneumothorax, which intervention takes highest priority?
- High-flow oxygen via non-rebreather mask
- Needle decompression of the affected side (Correct answer)
- Positive pressure ventilation with BVM
- Immediate chest tube insertion
Correct answer: Needle decompression of the affected side
Needle decompression of the affected hemithorax immediately relieves the life-threatening pressure buildup in tension pneumothorax.
Question 3: A patient with COPD is in moderate respiratory distress. SpO2 is 82%. What is the correct oxygen delivery approach?
- Withhold oxygen to avoid hypoxic drive suppression
- Apply a nasal cannula at 1-2 LPM only
- Titrate oxygen to achieve SpO2 of 88-94% (Correct answer)
- Administer 15 LPM via non-rebreather immediately
Correct answer: Titrate oxygen to achieve SpO2 of 88-94%
COPD patients should receive titrated oxygen targeting 88-94% SpO2 to correct hypoxia while minimizing hypoxic drive suppression risk.
Question 4: During treatment of a seizing patient, which action should be performed FIRST?
- Insert a bite block between the teeth
- Protect the patient from injury and maintain airway patency (Correct answer)
- Administer diazepam rectally
- Restrain the patient's limbs to prevent injury
Correct answer: Protect the patient from injury and maintain airway patency
Patient protection and airway management are the immediate priorities during an active seizure before any pharmacological intervention.
Question 5: A hypotensive trauma patient has received 2 liters of normal saline with no improvement. What is the MOST appropriate next step?
- Administer a third liter of saline rapidly
- Consider permissive hypotension and expedite transport (Correct answer)
- Switch to D5W for continued fluid resuscitation
- Administer dopamine at 5 mcg/kg/min
Correct answer: Consider permissive hypotension and expedite transport
Permissive hypotension (targeting MAP 50-65 mmHg) in hemorrhagic shock reduces coagulopathy and improves outcomes while expediting surgical intervention.
Question 6: Which of the following is the CORRECT sequence for managing an unresponsive adult with no pulse?
- Airway, Breathing, Circulation
- Compressions, Airway, Breathing (Correct answer)
- Airway, Compressions, Defibrillation
- Defibrillation, Airway, Compressions
Correct answer: Compressions, Airway, Breathing
Current AHA guidelines recommend CAB sequence (Compressions, Airway, Breathing) to minimize time to chest compressions in cardiac arrest.
Question 7: A burn patient has circumferential burns to both legs. Aside from airway management, which complication should be monitored MOST closely?
- Hypothermia from wet dressings
- Compartment syndrome compromising distal perfusion (Correct answer)
- Infection from open wounds
- Psychological distress from disfigurement
Correct answer: Compartment syndrome compromising distal perfusion
Circumferential burns create eschar that restricts swelling, causing compartment syndrome and loss of distal pulses requiring emergent escharotomy.
EMS Treatment Planning & Management 2
A 45-year-old male presents with crushing chest pain radiating to the left arm, diaphoresis, and nausea.
Which treatment priority is MOST appropriate?