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Section 1: AMLS Assessment & Primary Survey (Q1-10)
Q1. An EMS crew arrives at a motor vehicle collision scene. The vehicle is upright,
there is no fire or smoke, and traffic is controlled. The driver is conscious and seated.
What is the FIRST action the crew should perform?
A. Apply a cervical collar and perform a primary survey
B. Assess scene safety, don BSI, and determine the mechanism of injury
C. Immediately extricate the patient and begin transport
D. Obtain a complete SAMPLE history before any physical assessment
Correct Answer: B [CORRECT]
Rationale: The AMLS assessment algorithm always begins with scene size-up:
ensuring scene safety for responders, donning appropriate body substance isolation
(BSI), and evaluating the mechanism of injury (MOI) to predict injury patterns and
determine resource needs. Cervical collar application (A) follows MOI determination.
Immediate extrication (C) without assessment may worsen injuries. SAMPLE history
(D) is obtained after the primary survey, not before.
Q2. During the primary survey of a trauma patient, the rescuer notes gurgling
respirations, decreased breath sounds on the right, and jugular venous distension.
The trachea is deviated to the left. What is the MOST likely condition?
,A. Hemothorax
B. Tension pneumothorax
C. Flail chest
D. Simple pneumothorax
Correct Answer: B [CORRECT]
Rationale: Tension pneumothorax presents with hypotension, JVD, absent breath
sounds, hyperresonance, and tracheal deviation (late sign) due to progressive
accumulation of air under pressure in the pleural space with mediastinal shift.
Hemothorax (A) presents with dullness to percussion, not hyperresonance. Flail chest
(C) shows paradoxical chest wall movement. Simple pneumothorax (D) does not
cause hemodynamic compromise or tracheal deviation.
Q3. A 45-year-old patient has a GCS of 14 (E4, V4, M6), equal and reactive pupils, and
a blood glucose of 48 mg/dL. The patient is confused but following commands. What
is the priority intervention?
A. Administer naloxone 2 mg IV
B. Administer D50 25g IV and recheck glucose
C. Perform a full neurological examination before treatment
D. Apply a non-rebreather mask at 15 L/min
Correct Answer: B [CORRECT]
Rationale: Hypoglycemia (glucose <60 mg/dL) is a reversible cause of altered mental
status that must be corrected immediately per the AEIOU-TIPS mnemonic. D50
administration restores glucose and prevents neuroglycopenic injury. Naloxone (A) is
indicated for suspected opioid overdose, not hypoglycemia. Delaying treatment for a
full neuro exam (C) risks seizure or permanent neurologic damage. Oxygen (D) is not
the priority when hypoglycemia is the identified cause.
Q4. A patient involved in a high-speed MVC has a patent airway, adequate
respirations, and strong radial pulses. Capillary refill is 2 seconds. The patient is alert
, and oriented but complains of severe abdominal pain. What is the appropriate
transport decision?
A. Stay and play: perform a detailed secondary exam on scene
B. Load and go: transport immediately to a trauma center
C. Stay and play: administer pain medication and reassess
D. Load and go: transport to the nearest community hospital
Correct Answer: B [CORRECT]
Rationale: High-speed MVC with severe abdominal pain suggests potential intra-
abdominal hemorrhage or solid organ injury. Per AMLS protocols, patients with
significant mechanism of injury and concerning findings require rapid transport to a
trauma center (load and go). Scene time should be <10 minutes for unstable or
potentially unstable patients. Staying on scene (A, C) delays definitive care.
Community hospital (D) lacks trauma surgery capabilities.
Q5. During reassessment of a stable patient, the rescuer should perform a focused
reassessment every:
A. 2 minutes
B. 5 minutes
C. 15 minutes
D. 30 minutes
Correct Answer: C [CORRECT]
Rationale: AMLS reassessment protocols require reassessment every 5 minutes for
unstable patients and every 15 minutes for stable patients. This allows trending of
vital signs and early identification of deterioration. Two minutes (A) is excessive for
stable patients. Five minutes (B) is reserved for unstable patients. Thirty minutes (D) is
too long and may miss early signs of decompensation.