NTN Emergency Medical Procedures 2 — Questions and Answers
Question 1: During CPR on an adult, what is the correct compression-to-breath ratio for a single rescuer?
- 15:2
- 30:2 (Correct answer)
- 20:2
- 15:1
Correct answer: 30:2
The American Heart Association recommends a 30:2 compression-to-breath ratio for single-rescuer adult CPR — 30 chest compressions followed by 2 rescue breaths.
The 30:2 compression-to-breath ratio was established by the American Heart Association (AHA) for single-rescuer adult CPR. This ratio maximizes blood flow by minimizing interruptions to chest compressions. Compressions should be performed at a rate of 100-120 per minute with a depth of at least 2 inches (5 cm). The 15:2 ratio is used for two-rescuer infant and child CPR. Maintaining high-quality compressions with minimal interruption is the most critical factor in cardiac arrest survival.
Question 2: A first responder arrives at a scene where a victim has a suspected spinal injury. What is the most appropriate method to open the airway?
- Head-tilt chin-lift
- Jaw thrust maneuver (Correct answer)
- Finger sweep
- Recovery position
Correct answer: Jaw thrust maneuver
The jaw thrust maneuver opens the airway without moving the cervical spine, making it the safest choice for suspected spinal injury patients.
The jaw thrust maneuver is the preferred airway opening technique for patients with suspected cervical spine injuries because it lifts the jaw forward without tilting the head or extending the neck. The rescuer places their fingers behind the angle of the mandible on both sides and lifts it forward. The head-tilt chin-lift, while effective for general use, involves neck extension that could worsen a spinal injury. Finger sweeps are used to remove visible obstructions, and the recovery position is for unconscious breathing patients without suspected spinal trauma.
Question 3: Which of the following is the correct order of assessment in the primary survey of a trauma patient?
- Breathing, Airway, Circulation, Disability, Exposure
- Airway, Breathing, Circulation, Disability, Exposure (Correct answer)
- Circulation, Airway, Breathing, Disability, Exposure
- Airway, Circulation, Breathing, Exposure, Disability
Correct answer: Airway, Breathing, Circulation, Disability, Exposure
The primary survey follows the ABCDE sequence: Airway, Breathing, Circulation, Disability (neurological status), and Exposure (full body examination).
The ABCDE approach is the standardized primary survey protocol for trauma patients: A (Airway with cervical spine protection) — ensure the airway is patent; B (Breathing and ventilation) — assess respiratory function; C (Circulation with hemorrhage control) — evaluate blood pressure, pulse, and control bleeding; D (Disability) — assess neurological status using GCS or AVPU; E (Exposure) — fully undress the patient to identify all injuries while preventing hypothermia. This systematic approach ensures life-threatening conditions are identified and treated in order of priority.
Question 4: A firefighter encounters a victim experiencing anaphylactic shock from a bee sting. The victim has their own prescribed epinephrine auto-injector. Where should the injection be administered?
- Upper arm (deltoid muscle)
- Outer mid-thigh (vastus lateralis) (Correct answer)
- Abdomen
- Buttocks (gluteal muscle)
Correct answer: Outer mid-thigh (vastus lateralis)
Epinephrine auto-injectors are designed to be administered in the outer mid-thigh (vastus lateralis muscle), which provides rapid absorption and is easily accessible even through clothing.
The outer mid-thigh (vastus lateralis muscle) is the recommended injection site for epinephrine auto-injectors because it provides rapid drug absorption due to good blood supply, is easily accessible, and the device can even be administered through clothing in emergencies. The injection should be held in place for several seconds to ensure full delivery. The deltoid muscle is used for many vaccinations but is not the recommended site for auto-injectors. After administration, the patient still requires emergency medical transport as symptoms may return when the epinephrine wears off (typically 15-20 minutes).
Question 5: What is the primary purpose of applying a tourniquet in the field?
- To reduce swelling at the injury site
- To prevent infection of an open wound
- To stop life-threatening extremity hemorrhage (Correct answer)
- To immobilize a fractured limb
Correct answer: To stop life-threatening extremity hemorrhage
Tourniquets are applied to control life-threatening hemorrhage from extremity wounds when direct pressure alone is insufficient to stop the bleeding.
Tourniquets are critical hemorrhage control devices applied to extremities to stop life-threatening bleeding when direct pressure fails. Modern evidence-based guidelines (including TCCC — Tactical Combat Casualty Care) support early tourniquet application for severe extremity hemorrhage. The tourniquet should be placed 2-3 inches above the wound (not over a joint), tightened until bleeding stops, and the application time recorded. Previously controversial due to concerns about limb damage, research has shown that tourniquet application within the recommended time window (generally up to 2 hours) rarely causes permanent damage and saves lives.
Question 6: During triage at a mass casualty incident, a victim is breathing but unconscious and has a respiratory rate of 32 breaths per minute. Under the START triage system, what color tag should this patient receive?
- Green (minor)
- Yellow (delayed)
- Red (immediate) (Correct answer)
- Black (expectant)
Correct answer: Red (immediate)
Under START triage, a respiratory rate above 30 breaths per minute classifies the patient as Red (immediate), indicating they need urgent medical attention.
The START (Simple Triage and Rapid Treatment) system is the standard mass casualty triage protocol. After confirming the patient is breathing, respiratory rate is assessed: over 30 breaths/minute automatically classifies the patient as Red (immediate priority). The full START algorithm: Can the patient walk? If yes → Green. Are they breathing? If not after repositioning → Black. Respiratory rate over 30 → Red. Capillary refill over 2 seconds (or no radial pulse) → Red. Cannot follow simple commands → Red. Otherwise → Yellow. This patient's respiratory rate of 32 and unconscious state clearly warrant a Red tag.
NTN Emergency Medical Procedures 2
During CPR on an adult, what is the correct compression-to-breath ratio for a single rescuer?