FDNY Emergency Medical Services 3 — Questions and Answers
Question 1: An infant presents with a heart rate of 55 bpm, poor perfusion, and decreased LOC despite oxygen therapy. The NEXT appropriate intervention is:
- Immediate synchronized cardioversion
- Chest compressions and prepare for IV/IO access (Correct answer)
- Adenosine 0.1 mg/kg rapid IV push
- Atropine 0.5 mg IV bolus
Correct answer: Chest compressions and prepare for IV/IO access
Symptomatic bradycardia with poor perfusion in an infant unresponsive to oxygenation requires immediate CPR and vascular access per pediatric guidelines.
Question 2: A patient with a known history of diabetes is found unresponsive. Blood glucose reads 28 mg/dL. No IV access can be established. The BEST alternative route for dextrose administration is:
- Sublingual glucose gel
- Intraosseous (IO) access (Correct answer)
- Oral dextrose solution via nasogastric tube
- Rectal glucagon suppository
Correct answer: Intraosseous (IO) access
When IV access fails, IO access allows rapid administration of dextrose in an unresponsive hypoglycemic patient.
Question 3: During endotracheal intubation, the colorimetric CO2 detector shows a PURPLE color after 6 ventilations. This MOST likely indicates:
- Correct tracheal tube placement
- Esophageal intubation (Correct answer)
- Right mainstem bronchus intubation
- Pulmonary edema interfering with readings
Correct answer: Esophageal intubation
A persistent purple (negative) reading on a colorimetric CO2 detector after 6 ventilations strongly suggests esophageal intubation requiring immediate tube removal.
Question 4: A 70-year-old patient presents with sudden-onset tearing chest pain radiating to the back between the shoulder blades. Blood pressure is 190/110 in the right arm and 150/90 in the left arm. You MOST suspect:
- Acute myocardial infarction
- Pulmonary embolism
- Aortic dissection (Correct answer)
- Hypertensive emergency without end-organ damage
Correct answer: Aortic dissection
Tearing back pain with a blood pressure differential between arms is a classic presentation of aortic dissection requiring rapid transport.
Question 5: Which of the following is the CORRECT compression-to-ventilation ratio for two-rescuer CPR on a 4-year-old child without an advanced airway?
- 30:2
- 15:2 (Correct answer)
- 30:1
- 15:1
Correct answer: 15:2
Two-rescuer pediatric CPR without an advanced airway uses a 15:2 ratio to provide more frequent ventilations than in adult CPR.
Question 6: A patient with COPD is in respiratory distress with an SpO2 of 82%. The MOST appropriate initial oxygen delivery device is:
- Nasal cannula at 2 L/min to avoid hypoxic drive suppression
- Non-rebreather mask at 15 L/min
- Bag-valve-mask with 100% oxygen
- Venturi mask titrated to achieve SpO2 of 88-92% (Correct answer)
Correct answer: Venturi mask titrated to achieve SpO2 of 88-92%
In COPD patients, a Venturi mask allows precise oxygen titration to a target SpO2 of 88-92%, preventing both dangerous hypoxia and hypercapnic drive suppression.
Question 7: When documenting patient care, which principle is MOST critical under FDNY EMS protocols?
- Document only positive findings to keep the PCR concise
- Record vital signs at least once per transport regardless of patient stability (Correct answer)
- Complete the PCR before transferring care to the receiving facility
- Document the patient's subjective complaints but not objective findings
Correct answer: Record vital signs at least once per transport regardless of patient stability
FDNY protocols require at minimum one full set of vital signs documented per transport, with additional sets for unstable or changing patients.
FDNY Emergency Medical Services 3
An infant presents with a heart rate of 55 bpm, poor perfusion, and decreased LOC despite oxygen therapy.
The NEXT appropriate intervention is: