EMS Treatment Planning & Management 3 — Questions and Answers
Question 1: A patient is found unconscious with pinpoint pupils, slow respirations (6/min), and cyanosis. After establishing the airway, what is the NEXT priority treatment?
- Administer activated charcoal via NGT
- Administer naloxone (Narcan) per protocol (Correct answer)
- Apply a non-rebreather mask at 15 LPM
- Start an IV and draw blood samples
Correct answer: Administer naloxone (Narcan) per protocol
Naloxone rapidly reverses opioid-induced respiratory depression and is indicated for this classic opioid toxidrome presentation.
Question 2: When managing a patient with anaphylaxis, which medication is the FIRST-LINE treatment?
- Diphenhydramine (Benadryl) 50 mg IV
- Methylprednisolone (Solu-Medrol) 125 mg IV
- Epinephrine 0.3 mg IM (1:1000) (Correct answer)
- Albuterol via nebulizer
Correct answer: Epinephrine 0.3 mg IM (1:1000)
Epinephrine 1:1000 administered IM into the anterolateral thigh is the first-line and life-saving treatment for anaphylaxis.
Question 3: A trauma patient is immobilized on a long backboard in cold weather. After 30 minutes, which complication becomes a priority concern?
- Pressure ulcer formation
- Hypothermia (Correct answer)
- Deep vein thrombosis
- Aspiration pneumonia
Correct answer: Hypothermia
Trauma patients lose heat rapidly due to exposure, impaired thermoregulation, and wet clothing, making hypothermia prevention critical during transport.
Question 4: For a pediatric patient in respiratory distress, which finding indicates immediate need for positive pressure ventilation?
- Respiratory rate of 30/min
- SpO2 of 94% on room air
- Inadequate chest rise with severe retractions (Correct answer)
- Mild nasal flaring with good skin color
Correct answer: Inadequate chest rise with severe retractions
Inadequate chest rise despite significant accessory muscle use indicates respiratory failure requiring immediate BVM ventilation.
Question 5: Which intervention is CONTRAINDICATED when managing a patient with suspected epiglottitis?
- Keeping the patient in a position of comfort
- Allowing the patient to hold their parent (pediatric)
- Attempting to visualize the oropharynx with a tongue depressor (Correct answer)
- Administering humidified oxygen
Correct answer: Attempting to visualize the oropharynx with a tongue depressor
Examination of the oropharynx in epiglottitis can cause complete laryngospasm and total airway obstruction.
Question 6: A patient with known diabetes presents with altered mental status, cool diaphoretic skin, and a blood glucose of 42 mg/dL. What is the CORRECT treatment?
- Administer glucagon 1 mg IM if unable to establish IV (Correct answer)
- Administer insulin per sliding scale protocol
- Administer oral glucose gel for all hypoglycemic patients
- Transport without treatment and monitor glucose en route
Correct answer: Administer glucagon 1 mg IM if unable to establish IV
When IV access cannot be established in an unconscious hypoglycemic patient, glucagon 1 mg IM stimulates hepatic glycogenolysis to raise blood glucose.
Question 7: A patient experiencing a hypertensive emergency has a BP of 220/130 mmHg with altered mental status. What is the field management priority?
- Rapidly lower BP to normal range with labetalol
- Avoid any medications and transport immediately
- Lower BP by no more than 25% in the first hour per medical direction (Correct answer)
- Administer nitroglycerin to rapidly reduce afterload
Correct answer: Lower BP by no more than 25% in the first hour per medical direction
Rapid BP reduction in hypertensive emergency can cause cerebral ischemia; a controlled reduction of no more than 25% in the first hour is the standard.
EMS Treatment Planning & Management 3
A patient is found unconscious with pinpoint pupils, slow respirations (6/min), and cyanosis.
After establishing the airway, what is the NEXT priority treatment?