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252 Cards in this Set
- Front
- Back
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Your entire assessment of a patient should:
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Appear to be a seamless process
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Gathering a patient's medical history and performing an in-depth physical examination should occur:
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Once the initial assessment and correction of life threats is completed
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A key part of making your practice of prehospital care successful is for you to:
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Develop and cultivate your own style of assessment and an overall strategy for evaluating and providing care for the patients you will encounter in the unique and varied circumstances in the field setting
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In prehospital care, the priorities of evaluation and treatment are based on:
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The degree of threat to the patient’s life
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Which of the following is NOT a part of your overall job as a paramedic?
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Always remember that your overall job as a paramedic is to quickly identify your patient’s problem(s), set your care priorities, develop a patient care plan, and quickly and efficiently execute the patient care plan.
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When determining whether a patient is sick, your MOST effective tool is often:
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A quick visual assessment based on the chief complaint, respiration's, pulse, mental status, and skin signs and color.
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You are in the BEST position to decide what, if any, care needs to be provided at the scene versus en route to the hospital once you:
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Have qualified whether your patient is sick or not sick, and then you must quantify how sick the patient is.
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You will MOST likely make your field diagnosis of a patient based on the:
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Patients history and chief complaint.
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The paramedic must make a field diagnosis in order to:
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Get the info needed to make the best decisions for your patient.
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Which of the following statements regarding the patient assessment process is correct?
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(all correct) Ask questions relevant to the patients chief complaint. Think of the assessment as a “fluid process”. As the patient interview unfolds, you need to be able to change the sequence of your questioning as the situation or patients condition dictates.
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On most runs, the two MOST important pieces of patient history information that you need to obtain initially are the:
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Patient’s Name and Chief Complaint
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After determining that the scene is safe, the FIRST step in approaching a patient is to:
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Introduce yourself and to explain that you are a paramedic
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Asking the patient about the date, time, location, and events surrounding the current situation will enable you to:
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Determine if the patient is (A&Ox4) Alert to Person, Place, Time and Event
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When a patient presents with two seemingly unrelated complaints, it is MOST important for the paramedic to determine:
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If the two complaints are related. If they are not related, which one will take priority.
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The history of present illness is MOST accurately defined as:
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A clear sequence and chronologic account of the patient’s sign and symptoms, that is, what happened and when.
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Which of the following questions would be of LEAST pertinence when trying to determine a patient's current health status?
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“ You will also need to ask about any accidents or injuries the patient had within the last month or so and about any operations or hospitalizations within the last 6 months or so.
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Which of the following questions will allow you to gain insight quickly when performing a check of a patient's body systems?
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“Has your doctor ever told you that you have a heart, lung or brain problem?”
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Your patient will MOST likely develop a good first impression of you if you:
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Your appearance should be professional and your demeanor positive and friendly.
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Working to ensure a patient's privacy, confidentiality, and comfort level will:
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Will go a long way toward establishing positive patient rapport and encourage more honest, open communication.
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The paramedic should always address a patient:
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Ask the patient his/her name and how he/she would like to be addressed.
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Using casual nicknames can be especially problematic when:
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Cultural differences exist between you and the patient.
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EMS providers who read off a list of questions to the patient to fill in all the blanks on the run report:
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Tend to make little or no eye contact.
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When transferring a geriatric patient from a hospital to an extended care facility, it is MOST important to:
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Review the patient’s transfer paperwork.
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The MOST important thing you can do to facilitate the exchange of information between you and your patient is to:
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Pay Attention!
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The MOST appropriate initial question to ask a patient who complains of chest pain is:
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Can you describe the pain?
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Reflection is a powerful tool for getting a good patient history because:
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Two reasons: 1) Reflection usually does not break the flow of your patient’s thoughts. It helps you both stay focused. 2 )The information you will obtain is not biased by “leading the patient”.
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When a patient tells you that he or she takes a “water pill,” it is MOST important for you to:
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Clarify what they mean.
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An empathetic attitude:
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“Putting yourself in his or her shoes”. Empathy can help you set your patient on a path to healing ~ no matter what the diagnosis.
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When asking a patient if he or she uses illegal drugs, you will MOST likely get accurate information if you:
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Remain professional and nonjudgmental.
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If a patient refuses to give you information, you should:
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Infer what could be causing the distress and then ask the patient if you are right (i.e, “So, if I understand you correctly...”)
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Before asking a patient how he or she is feeling, you must FIRST:
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Ask for facts first, then follow up. Establish a rapport before asking how they are feeling.
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Which of the following questions would be MOST appropriate to ask when attempting to determine the quality of a patient's pain?
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Does the pain come and go, or is it constant?
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It is appropriate to ask, “Would you say the pain is similar to or worse than with previous episodes?” when determining the ¬¬¬___ of a patient's pain.
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Severity
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The mnemonic “OPQRST” is a tool that:
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Offers an easy-to-remember approach to analyzing a patient’s chief complaint that is simple and effective.
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When documenting the severity of a patient's pain, it is also important to:
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Note how distressed the patient appears: mild, moderate, or severe.
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Throughout the patient assessment process:
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Look for nonverbal communication, such as changes in facial expression, heavy sighs, or aggressive gestures (finger pointing)
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When assessing a patient who is under the influence of alcohol, it is MOST important to remember that:
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Do not assume that all that you are told is completely accurate and keep your best professional attitude as you work with patients you suspect of using drugs or alcohol. Alcohol may mask any number of signs and symptoms.
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If you suspect that a patient has been abused, you should:
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Never hesitate to call for law enforcement personnel.
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Which of the following findings would make you the LEAST suspicious for abuse or domestic violence?
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(Suspicious findings WOULD INCLUDE) injuries inconsistent with the information you are given, or multiple injuries in various stages of healing.
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When asking questions pertaining to a patient's sexual history, it is MOST important to remember that:
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Private setting is essential, also certain factors may inhibit truthful response.
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If a patient does not respond to a question within a couple of seconds, he or she:
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May simply be searching for the answer. Trying to decide if he can trust you.
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A patient who is overly talkative during your assessment:
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May just be that way, also multiple clinical causes for over talkativeness (eg. fight/flight recovery). May have abused methamphetamines.
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When dealing with a patient who has multiple complaints, the MOST effective way to develop an appropriate care plan is to:
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Prioritize the pt complaints.
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The paramedic must always keep in mind that the information he or she fails to obtain:
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Could be the info needed to treat the pt.
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The MOST negative immediate consequence of providing inappropriate reassurance to your patient in the prehospital setting is:
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Your patient could choose not to share quite as much information as he or she might have under other circumstances, leaving you with less information rather than more.
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If a patients family member is hostile and begins shouting at you, you should:
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Tell the person directly that if he or she continues to shout, you will not feel safe enough to do your assessment and will need to call law enforcement personnel.
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If a hostile family member suddenly leaves the room, especially in the middle of a conversation with him or her, you should:
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Follow the person, while working to calm him or her and defuse the situation. What you are also doing is making certain the person doesn't get a gun and shoot you,your partner or their spouse.
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Which of the following statements regarding an intoxicated patient is MOST correct?
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(ALL CORRECT) Taking a good medical history becomes very difficult. Intoxication may mask symptoms, such as pain. With intoxication also comes a decrease in patience.
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The MOST effective way to obtain a medical history from a patient who is crying is to:
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Keep a calm demeanor and patient approach; appropriate touch, such as a hand on the shoulder; and a quite, “I’m in control now” tone of voice will help get the crying to stop.
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Situational depression is:
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A reaction to a stressful event in a patient’s life.
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If your patient becomes seductive or makes sexual advances towards you, you should advise the patient that your relationship with him or her is strictly professional and then:
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Try to keep your partner, law enforcement, or a family member in the room with you at all times.
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A patient who gives the emergency department physician completely different information than he or she gave to you in the field:
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Patients may be too frightened or embarrassed to give particular information to a paramedic but will give a physician the information. May have an organic condition such as a brain tumor.
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When caring for a patient who is mentally challenged:
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You may need to get information from family members, friends, or another caregiver.
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When your patient is a non-English-speaking person, his or her child is often able to function as an interpreter because:
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Children absorb a new language quickly in their school.
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Which of the following is NOT an effective way of obtaining a medical history from a patient who is totally deaf?
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The following are effective ways: When addressing a patient who is totally deaf but can read lips, address them face-to-face, slowing your speech slightly so that you are speaking clearly. Use an interpreter who knows ASL. Write out the communication.
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Objective patient information is:
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Objective (based on fact or observable) information is obtained from a pt about his or her overall state of health
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___ entails gently striking the surface of the body, typically where it overlies various body cavities.
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Percussion
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Other than overall patient appearance, the patient's ___ is/are the MOST objective data for determining his or her status.
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Vital signs
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The residual pressure in the circulatory system while the left ventricle is relaxing is called the:
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Diastolic pressure
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Blood pressure is the product of:
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Cardiac output & peripheral vascular resistance, so it includes two components: systolic and diastolic pressure
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To obtain a heart rate in infants younger than 1 year of age, you should:
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Palpate the brachial artery to assess the pulse
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A conscious patient's respiratory rate should be measured:
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By inspection of the patient’s chest, but respiratory movements can also be assessed by visualizing portions of the abdominal wall, neck, face, and overall accessory muscle use.
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When using a tympanic device to obtain a patient's body temperature, you should:
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Be aware of extrinsic factors that may increase or decrease the temperature reading.
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Which of the following factors would likely NOT skew a pulse oximetry reading?
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(ARE LIKELY) hypotensive or cold patient, carbon monoxide poisoning, abnormal hemoglobin (ie, sickle-cell disease), vascular dyes, patient motion, and incorrect placement. (WOULD NOT) hypertension
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An appropriate sized blood cuff should:
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The cuff should be one half to two thirds the size of the upper arm.
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Which of the following statements regarding your general survey of the patient is MOST correct?
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(ALL CORRECT). The general survey begins as you approach the scene, simultaneously sizing up the situation and the patients overall presentation. A quick look at the environment and the general appearance of the patient provides a substantial amount of info before you ask the first question. The expression “sick or not sick” sums up the approach.
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The skin becomes ___ when red blood cell perfusion to the capillary beds of the skin is poor.
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Pallor
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A patient who does not respond to verbal or tactile stimuli is:
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Classified as U or Unresponsive
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Flushed skin is commonly seen as a result of all the following, EXCEPT:
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SIGNS INCLUDE: Patient’s with fever, and it may be seen in patients experiencing an allergic reaction.
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Poor skin turgor in an infant or child is MOST indicative of:
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Dehydration
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Changes in hair growth or loss of hair are LEAST suggestive of:
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An underlying endocrine disorder, such as diabetes, or may result from treatment modalities for disease processes (eg, chemotherapy or radiation treatment of cancer). (least suggestive of) an infection
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The pulse of the superficial temporal artery can be felt:
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Just anterior to the ear in the temporal region.
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Examination of the head is MOST important when assessing a patient who:
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Is a trauma patient or a patient with altered mental status or are unresponsive.
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Bulging of a child's anterior fontanelle is:
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Common while crying, pathologic when observed in a quiet child.
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A patient who complains of double vision has:
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Diplopia
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When assessing visual acuity in the prehospital setting, you should:
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Simple test such as light/dark discrimination and finger counting. Test each eye in isolation.
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The diameter and reactivity of a patient's pupils to light:
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Reflect the status of the brain’s perfusion, oxygenation, and condition.
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Asymmetry of the pupils:
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(Anisocoria, which can be found in 20 % of the population) may indicate significant ocular or neurologic pathology, but must be correlated with the Pt overall presentation.
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When assessing a patient's conjunctivae, you note they are injected. This means that the conjunctivae are:
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Injected means RED. The conjunctivae ought to be pink-not cyanotic, pale, or overly reddened.
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An opaque black area against the red reflex of the eye is indicative of:
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Cataracts
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Frank blood or clear, watery fluid draining from the ear canal following head trauma is MOST suggestive of a/an:
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Basilar skull fracture.
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Swollen lymph nodes in the anterior neck usually indicate:
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Infection
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All of the following are adventitious breath sounds, EXCEPT:
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(ALL CORRECT) Rales, Rhonchi, Wheezes, stridor.
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Percussion of the chest produces ___ if the pleural space is full of BLOOD.
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hyporesonance or dullness
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You would NOT expect to encounter decreased breath sounds in a patient with:
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Cardiac Tamponade.
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S1, the first heart sound, represents:
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Closure of the mitral and tricuspid valves “lub”.
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The fourth heart sound (S4):
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Considered a “gallop” rhythm, is a moderately pitched sound that occurs immediately before the normal S1 sound; it’s always abnormal. The S4 sound represents either decreased stretching (compliance) of the left ventricle or increased pressure in the atria. “bla” sound.
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When auscultating heart sounds, you should place your stethoscope at the:
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At the fifth intercostal space over the apex of the heart.
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A bruit indicates ___ blood flow, and is MOST significant in the ___ arteries.
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Turbulent, carotid
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To appreciate the S1 sound:
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Ask the patient to breathe normally and hold the breath on expiration.
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Arterial pulses are a physical expression of:
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Systolic blood pressure.
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Distention of the jugular veins indicates:
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Depending on the clinical situation, patients with JVD may be experiencing cardiogenic shock or have a ruptured cardiac valve. In the setting of chest trauma, neck vein distention and hypotention may symbolize a tension pneumothorax or pericardial tamponade. Indicates increased venous capacitance
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When examining the anterior abdomen of a patient who complains of abdominal pain:
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It’s best to make the patient as comfortable as possible. The patient must be in the supine position.
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A patient who is absolutely still and resists any movement should be suspected of having:
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Peritonitis
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Which of the following statements regarding ascites is MOST correct?
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Typically seen in patients who suffer from liver disease. Ascites is the collection of fluid within the peritoneal cavity
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What part of the abdominal exam is of LEAST value in the prehospital setting?
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Auscultation of the abdomen.
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Abdominal guarding is MOST commonly encountered in patients with:
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Peritoneal irritation (i.e, organ becomes inflammed or hollow organ ruptures and empties contents into paritoneal cavity)
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Visceral abdominal pain is:
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Less discrete guarded tenderness to palpation. Can be associated with various degrees of bowel obstruction.
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Assessment of the female genitalia:
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Performed in a limited and discreet fashion. Reasons to examine include concern over life-threatening hemorrhage or imminent delivery in chidbirth. Limit exam to inspection only.
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A pathologic fracture occurs when:
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When normal forces are applied to abnormal bone structures
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Clinical signs of an inflamed joint include all of the following, EXCEPT:
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SIGNS INCLUDE: swelling, tenderness, increased heat, redness, ecchymosis, decreased function, deformity, diminished strength, atrophy or asymmetry from one side to the other
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Structural integrity of the pelvis is assessed by:
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Applying pressure to the iliac crests and pushing in and then down
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The diagnosis of a problem involving the shoulder can often be made by simply:
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Simply by noting the patient’s posture at the time of first contact
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Lower extremity shortening and/or internal or external rotation are findings often associated with:
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An injury to the proximal aspects of the lower extremity
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Intermittent claudication is MOST accurately defined as:
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Cramp-like pain in the lower legs due to poor circulation
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In general, +3 pitting edema is characterized by indentation of the skin to a depth of:
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1/2” - 1”
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The MOST clinically significant indicator of ischemia in a limb is:
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The loss of a palpable pulse
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You would MOST likely encounter bilateral dependent edema in a patient with:
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1st- heart failure, 2nd- hepatic cirrhosis.
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An inward curve of the lumbar spine just above the buttocks is called:
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Lordosis
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At its worst, kyphosis can become a source of:
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Restrictive airway disease
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Babinski sign, grasping, and sucking sign are:
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Primative reflexes - normal in children.
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If a patient is able to sense smell, his or her ___ nerve is intact.
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Olfactory
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The optic nerve is a ___ nerve, and controls:
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Sensory, Light perception and vision.
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The vestibulocochlear nerve is responsible for the functions of:
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Hearing, balance perception.
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If a patient is able to shrug his or her shoulders and turn his or her head from left to right, the ___ nerve is likely intact.
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Spinal accessory
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If a patient's trigeminal nerve is intact, he or she should be able to:
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Motor:Chew; Sensory:face, sinuses, teeth.(Table 13-2) Check jaw clench; touch both sides of of face at forehead, cheeks, and jaw.
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When assessing muscle strength, a score of 5/5 indicates:
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A state of normal muscle tone.
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When scoring a patient's deep tendon reflexes, normally active reflexes would be assigned a score of:
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2+ “Active (expected response)”.
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The brachioradialis tendon is located:
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Proximal to the wrist.
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In contrast to dementia, delirium is:
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More consistent with an acute sudden change in mental status, secondary to some significant underlying aberration.
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When assessing a hemodynamically stable child, the toe-to-head approach is generally indicated for children who are:
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1 to 3 years of age.
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Proper documentation of your physical examination of a patient is MOST important because it:
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Ensures that an accurate historical accounting of the patients problems prior to entering the hospital will legally exist in the formal medical records.
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Documentation of your physical examination should be:
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When you are recording examination finding’s, note objective signs, pertinent negatives, and other similar relevant information.
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Which of the following actions will provide the BEST personal protection when caring for a patient on uneven terrain?
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take the time to make all lifts and moves safe/controlled
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The general type of illness a patient is experiencing is called the:
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nature of illness (NOI)
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Whether your patient's problem is medical or traumatic in origin, you must:
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Ask two questions, first “Is my patient sick?” a yes or no answer. Second “How sick is my patient?” attempts to rate the events severity. Answer both within 60-90 sec.
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It is MOST important to identify the age and sex of your patient because:
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Age can change how a patient presents.
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After performing your initial assessment of a patient, your next action should be to:
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Do a focused history and physical exam.
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When assessing an injured patient's mental status, the patient knows his name but is unable to recall the events that preceded the injury. From this, you can conclude that:
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This patient is A&O X1 to person and has his long-term memory but his short-term memory has been effected.
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Which of the following terms is MOST descriptive of an abnormal mental status?
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GCS of 10 or less
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What is the Glasgow Coma Scale (GCS) score of a patient who opens her eyes when you call her name, is confused when she speaks, and points to her area of pain?
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3,4,5=12
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Sonorous respirations are MOST likely caused by:
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“position problem”- likely from the tongue partially obstructing the airway
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A responsive patient who is talking or crying:
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has an adequate airway
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If manual positioning of a patient's head is required to keep his or her airway open, you should:
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you must choose an airway adjunct
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Tidal volume is MOST effectively assessed by:
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The book refers back to chapter 11 for an explanation of tidal volume, but the only info that is given, is the average tidal volume for an adult (approx. 500 mL).
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A patient with a blood pressure of 210/100 mm Hg would be expected to have a pulse that is:
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a patient who is hypertensive will produce a pulse that is more forceful than usual
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When the blood vessels supplying the skin are fully dilated, the skin becomes:
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Warm and Pink
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An unresponsive patient who has been breathing slowly and shallowly for an extended period of time would MOST likely have ___skin.
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“dusky gray or blue (cyanosis)”
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Stimulation of the sympathetic nervous system causes:
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Sweating
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The body's reaction to increased internal or external temperature would MOST likely cause the skin to become:
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Hot and moist
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A patient in shock due to internal bleeding will benefit MOST from:
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limited scene time and rapid transport
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For a responsive patient with a medical complaint, you will MOST likely form your working diagnosis based on information gathered during the:
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history-taking process
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The history of present illness is MOST accurately described as:
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information about the chief complaint, obtained using the OPQRST mnemonic
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The focused physical exam of a patient is guided by:
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information you gathered during the initial assessment and history-taking phase.
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Lung fields with areas of consolidation are MOST suggestive of:
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pneumonia
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The presence of rales during auscultation of the chest indicates all of the following conditions:
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pulmonary edema, heart failure, toxic inhalation, submersion.
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Diffuse pain caused by hollow organ obstruction and stretching of the smooth muscle wall is called ___ pain.
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visceral
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What type of pain has its origin in a particular location, but is described by the patient as pain in a different location?
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Referred pain
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A patient is generally considered to have orthostatic vital signs (a positive tilt test) when:
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the patient’s blood pressure shows a decrease in systolic pressure (up to 20mmHg), an increase in diastolic pressure of 10mmHg (a narrowing pulse pressure), and an increase on the heart rate by 20 beats/min.
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The MOST reliable means of attempting to determine an unresponsive medical patient's problem is:
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you must rely on a thorough head-to-toe physical examination plus the normal diagnostic tools
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Serial vital signs:
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(second and additional sets) provide comparative data to help you evaluate whether the patient’s condition is improving, status quo, or worsening
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Which of the following mechanisms of injury would be the LEAST likely to cause life-threatening injuries?
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HIGH POTENTIAL: ejection from any vehicle (car, motorcycle, or all-terrain vehicle), death of another patient in the same passenger compartment, falls from more than 20’ (or 3x the patient’s height), vehicle rollover (unrestraintd occupant), high-speed motor vehicle crash, vehicle-pedestrian collision, motorcycle crash, or penetrating wounds to the head, chest or abdomen
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Which of the following significant mechanisms of injury is unique to the infant and child?
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falls from more than 10’, a bicycle collision, or being struck by a vehicle
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A deformed steering wheel in conjunction with a deployed airbag indicates that the:
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seatbelt was not used (up-and-over collision, another source of life threatening internal injuries.)
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An unresponsive trauma patient:
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considered a high-risk, priority patient and requires immediate xport to a trauma center. (may have traumatic brain injury, stroke, hypoglycemia, or alcohol or drug intoxication)
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The rapid trauma assessment is usually performed:
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after the initial assessment and all life threats to airway, breathing, and circulation have been identified and addressed.
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When performing a rapid trauma assessment on a critically injured patient, it is MOST important to remember that:
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the most visible or painful injury may not be as serious as the most lethal injury (i.e., ruptured spleen), because its the least visible and painful.
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Upon completing your rapid assessment of an unresponsive trauma patient's head and neck, you should next:
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examine your gloves for signs of bleeding, and place a properly sized rigid cervical collar
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A difference in pulse quality from one lower extremity to the other:
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points to a potentially serious vascular disruption
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Which of the following tasks should you assign to another provider as you perform a rapid trauma assessment while your partner maintains c-spine control and manages the patient's airway?
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vital signs
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When assessing the head and face during the detailed physical exam, you should:
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Inspect and feel the entire cranium for signs of deformity or Asymmetry. (note any warm, wet areas, usually represent blood/CSF or combination)
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When assessing a trauma patient's chest, you should remember that:
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Couldn’t find a definitive answer, just the usual equal rise and fall/symmetry. And lung sounds in a least 6 fields.
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During the detailed physical exam of a trauma patient with a significant cardiac history, you should:
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Acquire a 12 lead ECG (If you have time For all Pt w/cardiac history at least run a 3 lead.)
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Bruising in the periumbilical area is indicative of:
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Cullen’s sign (indicative of intraperitoneal hemorrhage) Common causes are ruptured ectopic pregnancy and acute pancreatitis.
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Vascular compromise in a lower extremity is characterized by:
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This doesn’t make a lot of sense but its what i found in the book(pg 14.28 Bottom right paragraph) A significant variation in pulse strength in one extremity, especially when associated with pallor or cyanosis.
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A patient with dysarthria has:
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garbled or slurred speech.
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During a 20-minute transport of a critical patient, you should make a concerted effort to perform an ongoing assessment ___ times.
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4
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Which of the following assessment findings is MOST significant in a patient with penetrating chest trauma?
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Beck’s triad.
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After gathering information from the patient, scene, and any bystanders, you must next:
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evaluate the info
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Synthesizing information about a patient with multiple medical conditions involves:
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assessing each condition for it’s potential to have life threatening impact
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The care plan that you implement based on your working field diagnosis of a patient is almost always defined by:
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the protocols/standing orders of your EMS system
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Protocols, or standing orders, specify the paramedic's performance parameters, which:
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Define what a paramedic can do offline and when they must call medical control.
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The main disadvantage of patient care algorithms is that they:
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Only address classic patient care presentations, frequently don’t address vague patient complaints or address patients with multiple disease etiologies and patients who require multiple treatment modalities.
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If a patient's clinical presentation is not addressed in a specific algorithm, the paramedic must:
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Figure out what you should do in your patients best interest.
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Documenting difficulties such as darkness, limited access, and unruly crowds that you encounter while caring for a patient is MOST important because it:
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will help to justify your decisions made for patient care
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In order to be a competent and effective paramedic, it is MOST important for you to:
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be able to work under extreme pressure and be able to perform both quickly and effectively
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Once you determine that your patient is sick, you must next:
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“you must further be able to quantify how sick are they”
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Which of the following conditions or situations is the BEST example of a critical life threat that needs immediate care?
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Major multisystems trauma, devastating single-systems trauma, end-stage disease presentations, acute presentation of chronic conditions
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In EMS, the process of concept formation involves:
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Gathering information - things you see, hear, smell, or feel.
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Knowledge of anatomy, physiology, and pathophysiology are MOST important during the ___stage of critical thinking.
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Data Interpretation
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Comments such as “I can't believe you called EMS for this!”:
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Show a lack of interest in providing the best care possible.
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A negative attitude about any patient or patient care situation:
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Almost guarantees that the care you provide will be suboptimal
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A working diagnosis is MOST accurately defined as:
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what you feel is at the root of your patients problem, and what you will focus your patient care efforts on correcting.
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Which of the following scenarios MOST accurately depicts reflection in action?
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Reflection gives you the chance to continuously improve thinking and decision making, and, in turn, your patient care as you modify your experience base.
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The MOST effective way for the paramedic to avoid tunnel vision is to:
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always keep your mind open to all the possible causes of your patient’s current condition.
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___ occurs after a call is over and commonly is associated with the run review or critique.
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The last stage in the critical thinking process
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Uncertainty regarding the specific cause of a patient's problem is called:
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medical ambiguity.
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Which of the following situations is MOST challenging with regard to your critical thinking and decision-making skills?
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Patients whose conditions fall somewhere around the midpoint on the spectrum between “no big deal” minor and “oh my gosh” serious pose as the greatest challenge.
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The hormonal effects associated with the fight-or-flight response can affect your performance as a paramedic by:
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(sensory overload) impaired critical thinking skills or diminished concentration and assessment abilities
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Which of the following actions has the LEAST impact on the paramedic's ability to think under pressure?
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POSITIVES: Take a moment to scan the situation. Take another moment to stop and think. Make decisions and act on behalf of the patient. Stay calm, and maintain clear, concise mental control. Plan to regularly and continually re-evaluate the patient.
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When reading the scene, the paramedic must remember that:
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is a relative goldmine of information and becomes unavailable once you initiate transport to the hospital. Primary elements include: evaluate the overall safety of the situation, the environmental conditions, the immediate surroundings, access and exit issues, and evaluating the mechanism of injury
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Which of the following is NOT a typical element to evaluate when reading the scene of a motor vehicle crash?
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primary elements (evaluate the overall safety of the situation, the environmental conditions, the immediate surroundings, access and exit issues, and evaluating the MOI)
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When you introduce yourself to your patient and ask why 9-1-1 was called, the patient looks at you, shakes your hand, and answers your questions appropriately. From these findings, you can gather that the patient:
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that the patient has a Glascow Coma Scale score of 15 (spontaneous eye opening, follows commands, appropriate verbal response)
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When a patient advises you of his or her chief complaint, you should:
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determine if this is a new problem or the worsening of a preexsisting condition
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When caring for a critically ill patient, three or more sets of vital signs will allow you to:
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assess trends and to reassess whether the patient’s condition is stabilizing, getting better, or getting worse
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After addressing any life threats in the order in which you find them, you should next:
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consider the worst case scenario that could be causing Pt’s symptoms and rule it in or out
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Given the number of possible diagnoses in any situation and the limited physical and technical resources of the field. you will MOST likely:
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Be treating Pt’s that may not be able to be diagnosed until they reach the hospital
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When caring for a patient with multiple pathophysiologies, it is MOST important for the paramedic to:
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add them up as you develop your care plan to make sure nothing is overlooked that can be addressed in the field setting.
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No matter how sure he or she is of the working diagnosis, the thinking paramedic must:
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Always keep part of the thought process open to other possibilities.
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Excellence in prehospital care is:
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the gradual result of you as a provider constantly striving to improve your practice, which requires that you always have an attitude that is open to learning.
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Which of the following is a subjective finding?
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the symptoms a pt describes (degree of pain)
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All of the following are subjective findings:
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again, anything you can’t observe directly or measure
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When providing patient care, it is MOST important that you maintain effective communication with:
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your partner
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During a mass-casualty incident (MCI), data collection is of importance for:
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pt care totals, severity of injuries, mass care procedures
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Notification of EMS usually occurs when:
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Someone tells EMS that an emergency exists.
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Devices that allow your voice to be transmitted when a button is pushed and allow the listener to hear you when the button is released are called:
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Push-to-talk
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In contrast to analogue telecommunications equipment, digital telecommunications equipment:
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Offer many advantages in terms of speed, privacy, programability and GPS.
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Under the instructions of a good emergency medical dispatcher (EMD), a layperson should be able to:
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Clear an obstructed airway, perform chest compressions or reassuring the patient can be carried out.
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In recent years, the use of telemetry has returned because:
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The AHA recommended that a 12 lead ECG be taken and transmitted to the receiving facility for all patients with potential acute coronary syndrome.
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The term “frequency,” as it applies to radio communications, is MOST accurately defined as:
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how frequently the wave recurs in a given time (usually 1 second)
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Low-band frequencies:
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may have ranges up to 2,000 miles but are unpredictable because changes in ionospheric conditions may cause “skip interference”, with patchy losses in communication
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Biotelemetry is MOST accurately defined as:
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is the capability of measuring vital life signs and transmitting them to a distant terminal
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All of the following factors may cause distortion of an ECG signal, EXCEPT:
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FACTORS INCLUDE: muscle tremor, loose ECG electrodes, sources of 60-cycle alternating current (AC), attenuation (reduction) of transmitter power, caused by weak batteries or transmission beyond the range of the transmitter
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At minimum, sending the 12-lead ECG of a patient with chest pain to the emergency department physician via telemetry would:
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Allow the receiving hospital to have the appropriate resources (equipment, medications, personnel, etc.) prepared and ready, pending the arrival of the patient. Specifically, the administration of fibrinolytic therapy.
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Cellular telephones are more advantageous than regular two-way radios in that cellular telephones:
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For EMS: cell phones have a longer range than a two-way radio - For the Public: 911 service is free + cell phones have GPS capability
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In order for the paramedic to talk and transmit an ECG simultaneously on one frequency, a ___ system is required.
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multiplex
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Radio transmission distances from a mobile transceiver are reduced:
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in mountainous areas or where there are many tall buildings.
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A/an ___ receives a weak signal and retransmits it at a higher power on another frequency.
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repeater
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A base station decoder within the emergency department:
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translates a telemetry signal into an oscilloscope tracing
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Which of the following statements regarding the use of cellular telephones and landline telephones is MOST correct?
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Cellular and landline phones overcome problems caused by overcrowded ems radio frequencies.
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When communicating medical information via radio, you should be:
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Simple, brief, direct
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The FIRST principle of communicating by radio is:
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Clarity!
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When transmitting information via radio, you should:
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use a normal conversational tone of voice
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When transmitting data over the radio, you should NOT disclose the patient's:
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Name
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Which of the following words would be the MOST difficult to hear over the radio?
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Yes and no, use affirmative and negative
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When transmitting your radio report to the hospital, you should:
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Use standard formats agreed on by your EMS service for transmission of information
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When relaying medical information to a physician in person, you should:
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Be mindful of the of the information you are supplying
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Which of the following is NOT patient data that typically is communicated during your radio report to the hospital?
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ALL IMPORTANT
• Patients age/sex • Chief complaint • Brief pertinent history of illness or injury • Anything the physician needs to know about the patients other medical history relative to the current situation • Patients l.o.c and degree of distress • Vital signs • Pertinent physical findings in head to toe order • ECG findings • Treatment given and response |
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When a panicked person calls 9-1-1 for help: The EMD must:
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• Answer the telephone promptly
• Identify himself or herseld and the agency • Speak directly into the mouthpiece • Observe telephone courtesy • Take charge of the conversation |
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Which of the following information is of LEAST importance for the emergency medical dispatcher (EMD) to obtain from the caller?(ALL IMPORTANT)
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• The exact location of the patient
• The telephone number of the caller • The callers perception of the nature of his or her or the patients problem • Specific info concerning the patients condition • If the emergency is a motor vehicle collision find out vehicle type, number of persons, and apparent hazards at the scenes. |
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If the emergency medical dispatcher (EMD) suspects that your patient has a life-threatening emergency, the EMD should make you aware of the situation and then:
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provide instructions to the caller in very simple terms about emergency care techniques (such as airway maintenance, Heimlick maneuver, CPR, hemorrhage control)
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In order to ensure that all recorded times associated with an incident are accurate, the paramedic should:
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compare your times with those of the dispatcher to ensure accuracy an proper timekeeping. Several times are absolutely vital to be kept and documented for the accurate report writing.
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The patient care report (PCR):
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should be a detailed segment indication the elements of the call; a written record of the events that transpire during a call for service. It is a legal record for the call and is part of the patient’s medical record and the hospital’s ED chart.
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The MOST significant problem associated with making up your own medical abbreviations and documenting them on the patient care report is:
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can cause confusion and, in the worst cases, could lead to medication and treatment errors
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Data collected from the state EMS office for the purpose of research would likely NOT include:
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verify call volumes and skills used and include (# of calls an agency responds to, the types of calls, care provided, and patient outcomes.
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The National Emergency Medical Services Information System (NEMSIS):
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store the EMS data for each the states.
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The MOST effective way to maintain your own knowledge of standard medical terminology is to:
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learn the established and accepted medical terms and abbreviations for your EMS operation. Ongoing review of the A&P chapter.
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It is MOST important for the paramedic to exercise extreme care when using medical abbreviations because:
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Incorrect or inappropriate medical abbreviations can cause confusion and, in the worst cases, could lead to medication and treatment errors.
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Which of the following incident times is NOT commonly documented on the patient care report?
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Vital incident times include (time of call, dispatch, arrival at the scene, with patient, med administration, departure from scene, arrival at med facility, back in service)
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Which of the following documentation styles would likely be MOST difficult and time-consuming to apply in EMS?
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body systems approach
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Which of the following statements includes a pertinent negative?
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pertinent negative is described as: a record of negative findings that warrant no care or intervention but thorough and complete examination and history were performed
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When documenting a statement made by the patient or others at the scene, you should:
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indicate who made the statement and place the exact words in quotations
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The accuracy of your patient care report depends on all of the following factors, EXCEPT:
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DOCUMENTATION ACCURACY INCLUDES: times, narrative information, checkboxes, and it must be comprehensive and precise
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If you receive another call before completing the patient care report accurately for the previous call:
|
details may be forgotten and important information left out, or worse, inaccurate information may be written
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Prior to submitting a patient care report to the receiving hospital, it is MOST important for:
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should be reviewed, by the paramedic who authors them, for completeness, accuracy, grammar, spelling, and proper use of medical terminology and abbreviations, to help ensure a well-written and well-documented report
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When a competent adult patient refuses medical care, it is MOST important for the paramedic to:
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ensure that your Pt is well informed of the situation at hand. explain in detail and make sure the Pt fully understands the potential consequences of refusing, including death and have a witness.
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For purposes of refusing medical care, a patient's mental status may be considered impaired if he or she:
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Is not orientated to person, place, time, and event. or makes non sensical statments.
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If your response to a call for a traumatic injury is canceled, you should document:
|
Be sure to document who you were cancelled by, such as law enforcement, on the PCR.
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Which of the following statements regarding revisions or corrections to a patient care report is MOST correct?
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A poorly written patient care report:
|
might lead a judge or jury to decide in favor of the plaintiff.
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In contrast to paper documentation, computer-based documentation:
|
may assist you in writing accurate, timely, and legible reports.
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An accurate and legible patient care report:
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should be complete to the point that people reviving them, whether your medical director or the administrative office clerk billing for the service provided, can read them and understand exactly what transpired on the call.
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