After assisting a patient with her epinephrine auto-injector, you should:
A: give it to the patient to have it refilled.
B: replace the cover and place it in the trash can.
C: place the device in a puncture-proof container.
D: place the device in a red biohazard bag.
The correct answer is C;
Reason:
After any device is used that has the potential for causing an accidental needle stick or is otherwise contaminated, it should be placed in a puncture-proof container, which usually is red and has a biohazard logo on it. The cover of the auto-injector should never be replaced, nor should a needle be recapped. Epinephrine auto-injectors are not refillable.
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Your partner, a veteran EMT of 20 years, has been showing up late to work with increasing frequency over the last several shifts. When he arrives, he is in a bad mood and is clearly not interested in being at work. His behavior is MOST consistent with:
A: drug use.
B: burnout.
C: acute stress.
D: delirium.
The correct answer is B;
Reason:
Your partner’s behavior is consistent with burnout. Burnout is a condition of chronic fatigue, irritability, and frustration that results from mounting stress over time. Although burnout typically manifests after years of service in EMS, some EMTs begin to experience it in a very short period of time, especially if they work in EMS systems with a high call volume and low morale. Some people with burnout abuse drugs or alcohol; if you suspect this, you should report it to your supervisor immediately. The best way to prevent burnout is to recognize the signs of stress and take action to reduce it. An acute stress reaction occurs in response to a sudden, unexpected event; it is clear that your partner has had many stressful events over his career. Delirium is an acute change in cognitive ability; it commonly results from conditions such as hypoxia, hypoglycemia, and drug toxicity.
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While caring for a trauma patient, blood splashes into an EMT’s eyes. This is an example of:
A: infection.
B: indirect contact.
C: transmission.
D: exposure.
The correct answer is D;
Reason:
Exposure occurs when an individual comes in direct contact with blood or other bodily fluids. Examples of direct exposure include blood splashing into the eyes or mouth and an accidental stick with a contaminated needle or other sharp object. Exposure does not always result in disease transmission and subsequent infection; that depends on whether the patient has an infectious disease. Routine use of standard precautions will afford the EMT the best protection from exposure to an infectious disease.
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When the incident command system is activated at the scene, you should expect to:
A: be assigned one responsibility for the duration of the incident.
B: receive instructions and then function independently.
C: be immediately directed to the established treatment area.
D: report back to your section officer in between assignments.
The correct answer is D;
Reason:
The incident command system (ICS) was established in order to maximize effective operations at the scene and maximize the number of lives saved. Deviation from the ICS jeopardizes lives and increases the risk of losing control over the situation. When you arrive at the scene in which the ICS has been activated, you should report to the staging area, where you will be directed to the area in which you are needed. Report to the section officer of that area, receive your instructions, and carry them out. When you have completed your assignment, you must return to the section officer for further instructions. Depending on the situation, you may be sent to another section. The sections that you work in and the responsibilities that you are given may change during the incident. At no time should you attempt to function independently (freelancing); this defeats the purpose of the ICS and puts lives in jeopardy.
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Following a call in which a 6-week-old infant in cardiac arrest did not survive, your partner is exhibiting significant anxiety and irritability. How can you MOST effectively help him?
A: Allow him to voice his feelings to you.
B: Report his behavior to the medical director.
C: Recommend at least 12 hours of sleep.
D: Tell him that he needs psychiatric help.
The correct answer is A;
Reason:
Your partner is clearly having difficulty coming to terms with this call’s bad outcome. As his partner, you can be most effective during this time by simply listening and allowing him to voice his feelings. Bad feelings should never be kept bottled up. If your partner is still having difficulties, a formal critical incident stress debriefing (CISD) may be needed. Some EMS providers may require psychiatric or psychologic assistance; however, this is not a determination that you can make. At least 8 hours of sleep is healthy; however, in the face of a crisis, sleep does not make the problem go away.
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Which of the following statements regarding the use of an escort vehicle when en route to an emergency call is correct?
A: To avoid getting separated from the escort vehicle, you should closely follow it.
B: With an escort vehicle, the risk of an accident at an intersection is reduced significantly.
C: An escort vehicle should be used only if you are unfamiliar with the patient’s location.
D: An escort vehicle will allow you to arrive at the scene quicker.
The correct answer is C;
Reason:
Generally, escort vehicles should not be used when responding to an emergency scene. The biggest danger of using an escort occurs at intersections, which is where most ambulance crashes occur. Drivers may yield to the escort vehicle, but may not be prepared for a second vehicle following the escort (wake effect collision). The only time that an escort may be required is when you are unfamiliar with the location of the patient and need assistance getting there. If an escort must be used, you must follow at a safe distance of at least 500 feet.
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You are caring for a 6-year-old child with a swollen, painful deformity to the left forearm. As you communicate with the parents of this child, you should:
A: tell them that the child will be transported to the hospital.
B: ask them repeatedly how the child was injured.
C: make sure that they remain aware of what you are doing.
D: use appropriate medical terminology at all times.
The correct answer is C;
Reason:
When caring for any patient, it is important to keep both the patient and family aware of what you are doing. You should avoid medical terminology whenever possible because most laypeople will not understand what you are saying. The plain English approach is much more effective. When caring for children specifically, you should inform the parents of the need for ambulance transportation and why; doing so will provide them with the information necessary to make an informed decision. Asking the parents repeatedly how the child was injured may be construed by some as implying that the child was abused.
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A set of regulations and ethical considerations that define the extent or limits of an EMT’s job is called:
A: scope of practice.
B: the Medical Practices Act.
C: a duty to act.
D: confidentiality.
The correct answer is A;
Reason:
The set of legal regulations and ethical considerations that define the job of the EMT is called the scope of practice. The scope of practice provides a clear delineation of the EMT’s roles and responsibilities. Duty to act is defined as a legal obligation to respond to every call for help while on duty and in your jurisdiction, whether you are paid for your services or not. Confidentiality entails not releasing any patient information to those not directly involved in the care of the patient. The Medical Practices Act describes the minimum qualifications of those who may engage in emergency medical care and establishes a means of certification.
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Upon arriving at the scene of a multiple vehicle crash, you can see that at least two patients have been ejected from their vehicles. You should:
A: immediately triage the two patients.
B: treat the most critical patient first.
C: gather all of the patients together.
D: request at least one more ambulance.
The correct answer is D;
Reason:
One ambulance and two EMTs can effectively care for only one critical patient or two non-critical patients. As soon as you determine that the patient count exceeds your capabilities, you should immediately call for additional help. After doing this, you should begin the processes of triage and treatment.
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After arriving at a mass-casualty incident where other ambulances are already present, you should notify the dispatcher and then:
A: initiate care for the most critically injured patients.
B: repeat the triage process.
C: obtain information from the fire service commander.
D: report to the staging area.
The correct answer is D;
Reason:
Once you arrive at the scene of a mass-casualty incident where an incident command system has already been established, you should report to the staging area, the area designated for all incoming ambulances and resources. The staging officer will know where help is needed the most and will be able to direct your actions accordingly.
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Following an apparent terrorist attack, numerous patients present with shortness of breath and persistent coughing. A green haze is noted in the area in which the patients are located. Which of the following agents should you suspect they were exposed to?
A: V agent (VX)
B: Chlorine (CL)
C: Phosgene oxime
D: Tabun (GA)
The correct answer is B;
Reason:
The patient's signs and symptoms are indicative of a pulmonary (choking) agent, specifically chlorine (CL). Chlorine (CL) was the first chemical agent ever used in warfare. It has a distinct odor of bleach and creates a green haze when released as a gas. Initially, it produces upper airway irritation and a choking sensation. Later signs and symptoms include shortness of breath, chest tightness, hoarseness and stridor as the result of upper airway swelling, and gasping or persistent coughing. Phosgene, not to be confused with phosgene oxime (a blistering [vesicant] agent), is also a pulmonary (choking) agent. Tabun (GA) and V agent (VX) are examples of chemical nerve agents. Nerve agents are among the most deadly chemicals developed. Designed to kill large numbers of people with small quantities, nerve agents can cause cardiac arrest within seconds to minutes of exposure.
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A 30-year-old woman crashed her car into a tree at a high rate of speed. She is conscious and alert and has stable vital signs. She has some small lacerations and abrasions to her arms and face, but no obviously life-threatening injuries. As you are loading her into the ambulance, she tells you that she does not want to go to the hospital. You should:
A: ask a law enforcement officer to administer a breathalyzer test to determine if she has been drinking alcohol.
B: advise her that she is probably too emotionally upset to be able to refuse EMS treatment and transport.
C: advise the patient that she should be transported to the hospital because of the seriousness of the crash.
D: obtain a signed refusal from the patient and ask a law enforcement officer to transport her to the hospital.
The correct answer is C;
Reason:
The consequences of refusal should be explained to any patient who refuses EMS treatment and/or transport. After establishing that the patient can legally refuse treatment and transport (eg, he or she is of legal age AND has decision-making capacity), you must advise her that because of the significant mechanism of injury, the potential for critical injury or death exists, even though she may feel fine now. Once this is explained, and the patient understands and is willing to accept the possible consequences, obtain a signed refusal and ask an impartial person (eg, police officer) to witness the signed refusal.
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Which of the following practices will provide you with the highest degree of safety when responding to an emergency call?
A: Always requesting fire department assistance
B: Routinely using the lights and siren
C: Asking the police to escort you to the scene
D: Wearing your seatbelt and shoulder harness
The correct answer is D;
Reason:
Consistent safety practices, such as wearing your seatbelt and shoulder harness, driving with due regard for others, and avoiding excessive speed, will afford you the highest degree of safety when responding to an emergency call. Unless used to guide you to an area you are unfamiliar with, escort vehicles should be avoided. Escort vehicles are especially dangerous at intersections; as the escort vehicle proceeds through the intersection, other motorists often do not expect a second emergency vehicle to follow. As a result, they may pull out into the intersection, thinking it is clear, and collide with your ambulance (wake effect collision). The use of lights and siren increases the danger factor, especially if used in conjunction with excessive speed. Lights and siren ask for, not demand, the courtesy of the right of way.
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You and your partner have secured a trauma patient to a long backboard and are preparing to lift the backboard onto the stretcher. When doing so, you should:
A: recall that most of the patient’s weight is at the foot end of the backboard.
B: ensure that the strongest EMT is positioned at the head of the backboard.