EMT Practice Test – Cardiology, Resuscitation, Stroke

Identifying the patient’s transport priority would be a component of the patient’s primary assessment.  Scene safety is ascertained during the scene size up.  Calculating the specifics about the patient’s pain and reassessing vitals are done later on in the patient’s assessment process.

You should begin your CPR with chest compressions whenever you are faced with an unresponsive child with a pulse rate below 60.

Nitro-glycerine is a vasodilator. This means that it will increase blood flow to the heart and reduce systemic vascular resistance. Activated charcoal is used as an adsorbent, aspirin is an anti-platelet aggregate and epinephrine is a sympathomimetic.

Pedal enema and JVD are usually indications of right heart failure. Pulmonary edema is usually an indication of left heart failure. The patient’s signs and symptoms are not consistent with angina or asthma.

The pulmonary veins are the source of oxygenated blood to the left side of the heart. The right side of the heart receives deoxygenated blood from the venae cavae. Deoxygenated blood exits the right heart by way of the pulmonary arteries.

The coronary arteries send oxygenated blood directly to the heart. The carotid and cerebral arteries provide blood to the brain and the femoral arteries are found in the leg.

The pulmonary arteries are the only arteries that transport deoxygenated blood. The pulmonary veins are the only veins that transport oxygenated blood.

Aspirin is used to reduce platelet aggregation in the coronary arteries. It does not dilate coronary arteries, it does not reduce chest pain due to MI and it does not reduce acidosis.

When a patient is responsive, they should always be assessed using the ABC sequence during your initial assessment. A patient’s airway should always be assessed prior to their pulses, skin or blood pressure. Their circulation should not be assessed first (The CAB sequence) because responsive patients are not in need of CPR.

Shock, (which is also known as hypo perfusion) can develop as a result of inadequate tissue perfusion and when it disrupts the body’s homeostasis. It is not typically caused by the hyperactivity of an organ or by systematic vasoconstriction.

A normal capillary refill will occur in two seconds or less in an infant or child.

You should always assess a patient’s pulse at the brachial artery, when the patient is less than one year in age.

You must begin CPR with chest compressions, when there is an unresponsive child with a pulse below sixty beats per minute. This should be done before transporting the child and the AED is not is not indicated when dealing with patients who have a pulse.

When a patient is unresponsive, you should assess them by using the CAB sequence in order to ensure that chest compressions are started as soon as possible. An AED should never be applied unless cardiac arrest is confirmed.

Circulation in a unresponsive patient above one year of age should always be assessed at the carotid artery. The brachial artery is used to assess circulation in unresponsive patients, less than one year of age

The Cincinnati Prehospital Stroke Scale contains assessments for slurred speech, facial droop and arm drift.

Your patient’s signs and symptoms are consistent with a stroke, not a cardiac emergency or migraine headache. Signs of a TIA are quite similar to those of a stroke, however they usually resolve within 24 hours.

Oxygen must be administered as deemed necessary, in order to maintain a pulse oximeter of at least 94%. High flow oxygen is not recommended anymore for patients who have no signs of hypoxia and who have a pulse oximeter reading of at least 94%.

This patient is showing signs and symptoms of having had a stroke. These signs and symptoms are not consistent with an MI or with internal bleeding. Dementia doesn’t typically have an acute initial onset, rather it presents itself over time. It also doesn’t cause slurred speech or one-sided weakness.

As your patient, your partner is showing signs of a nearly complete airway obstruction due to a foreign object. (Most likely food) As he is conscious, abdominal thrusts should be administered immediately. You could encourage him to cough if he had a partial airway obstruction and there was adequate air exchange, but this was not the case here. Back blows are only used on conscious infants with an airway obstruction, not on adults. Your patient should not be placed in a supine position unless he was to lose consciousness.

Stroke patients will need to be transported to a facility that is capable of providing rapid assessment and intervention. Dyspnea, diabetic problems and syncope can usually be handled in an emergency department at any hospital.

Distributive Shock (DS) is caused by systematic vasodilation. Improper cardiac function can lead to cardiogenic shock. Serious bleeding can lead to hypovolemic shock and acute hypoglycaemia would lead to insulin shock.

Adult AED pads can definitely be used on a pediatric patient, if there are no pediatric AED pads available. The AED can be used on adults, children and infants if and when they are in cardiac arrest.

The liver is a solid organ and therefore would bleed profusely if ever injured. A laceration of the liver would likely lead to hypovolemic shock. A spinal cord injury would most likely lead to distributive shock due to vasodilation. Insulin shock is not a very common cause of hypovolemia, but DKA is. Appendicitis is more likely to lead to septic shock.