FDNY Emergency Medical Services 2 — Questions and Answers
Question 1: When assessing a patient in anaphylactic shock, which sign indicates the most immediate airway threat?
- Hives covering the torso
- Stridor and hoarseness (Correct answer)
- Hypotension below 90 mmHg
- Tachycardia above 120 bpm
Correct answer: Stridor and hoarseness
Stridor and hoarseness indicate laryngeal edema, signaling imminent airway obstruction that requires immediate epinephrine and airway management.
Question 2: An FDNY EMS unit arrives at a scene where a patient was struck by lightning. The FIRST action after ensuring scene safety is to:
- Begin CPR if the patient is pulseless (Correct answer)
- Remove the patient's metal jewelry
- Wait for ALS backup before touching the patient
- Check for entry and exit wound patterns
Correct answer: Begin CPR if the patient is pulseless
Lightning strike victims carry no residual electrical charge, so immediate CPR should be initiated if the patient is in cardiac arrest.
Question 3: A patient presents with pinpoint pupils, decreased respiratory rate of 6 breaths/min, and unresponsiveness. The MOST appropriate initial intervention is:
- Administer 50% dextrose IV
- Administer naloxone intranasally or IM (Correct answer)
- Apply 100% oxygen via non-rebreather mask
- Perform a 12-lead ECG
Correct answer: Administer naloxone intranasally or IM
The classic opioid toxidrome — pinpoint pupils, respiratory depression, and altered consciousness — requires naloxone to reverse the overdose.
Question 4: During a multiple-casualty incident, a patient is found apneic. After repositioning the airway, the patient remains apneic. Under START triage, this patient is categorized as:
- Immediate (Red)
- Delayed (Yellow)
- Minor (Green)
- Expectant/Deceased (Black) (Correct answer)
Correct answer: Expectant/Deceased (Black)
Under START triage, a patient who remains apneic after one airway repositioning attempt is tagged Black (expectant/deceased) to prioritize resources for salvageable victims.
Question 5: Which of the following best describes pulseless electrical activity (PEA)?
- Absent electrical activity with no pulse
- Organized ECG rhythm with no palpable pulse (Correct answer)
- Ventricular fibrillation resistant to defibrillation
- Asystole with occasional agonal beats
Correct answer: Organized ECG rhythm with no palpable pulse
PEA is defined as an organized cardiac rhythm on the monitor in the absence of a palpable pulse, requiring CPR and treatment of reversible causes.
Question 6: A construction worker fell 20 feet and is conscious, alert, and complaining of neck pain. The MOST appropriate spinal motion restriction method is:
- Rigid cervical collar only with the patient walking to the stretcher
- Manual in-line stabilization, cervical collar, and long backboard (Correct answer)
- Scoop stretcher alone without a cervical collar
- KED device with the patient remaining seated at height
Correct answer: Manual in-line stabilization, cervical collar, and long backboard
A significant mechanism with neck pain warrants manual in-line stabilization, a rigid cervical collar, and long backboard for full spinal motion restriction.
Question 7: When administering activated charcoal, which condition is an ABSOLUTE contraindication?
- Aspirin overdose within 30 minutes
- Acetaminophen ingestion 1 hour prior
- Patient with an unprotected airway or altered mental status (Correct answer)
- Tricyclic antidepressant overdose
Correct answer: Patient with an unprotected airway or altered mental status
Activated charcoal must never be given to a patient with an unprotected airway or altered mental status due to the high risk of aspiration.
FDNY Emergency Medical Services 2
When assessing a patient in anaphylactic shock, which sign indicates the most immediate airway threat?