PREHOSPITAL EMERGENCY CARE
, Table of Contents
PART 1: PREPARATORY AND PUBLIC HEALTH
1. Emergency Medical Service Systems, Research, and Public Health
2. Workforce Safety and Wellness of the EMT
3. Medical, Legal, and Ethical Issues
4. Documentation
5. Communication
6. Lifting and Moving Patients
PART 2: ANATOMY, PHYSIOLOGY, AND MEDICAL TERMINOLOGY
7. Anatomy, Physiology, and Medical Terminology
PART 3: PATHOPHYSIOLOGY
8. Pathophysiology
PART 4: LIFE SPAN DEVELOPMENT
9. Life Span Development
PART 5: AIRWAY MANAGEMENT, RESPIRATION, VENTILATION, AND OXYGENATION
10. Airway Management, Respiration, Ventilation, and Oxygenation
PART 6: ASSESSMENT
11. Vital Signs, Monitoring Devices, and History Taking
12. Scene Size-Up
13. Patient Assessment
PART 7: GENERAL PHARMACOLOGY AND MEDICATION ADMINISTRATION
14. General Pharmacology and Medication Administration
PART 8: SHOCK AND RESUSCITATION
15. Shock and Resuscitation
PART 9: MEDICAL
16. Respiratory Emergencies
17. Cardiovascular Emergencies
18. Altered Mental Status, Stroke, and Headache
19. Seizures and Syncope
20. Acute Diabetic Emergencies
21. Allergic and Anaphylactic Reactions
22. Toxicologic Emergencies and Infectious Diseases
23. Abdominal, Hematologic, Gynecologic, Genitourinary, and Renal Emergencies
24. Environmental Emergencies
25. Submersion Incidents: Drowning and Diving Emergencies
26. Vulnerable Populations: Psychiatric Emergencies and Psychosocial Issues
PART 10: TRAUMA
27. Trauma Overview: The Trauma Patient and the Trauma System
28. Bleeding and Soft Tissue Trauma
29. Burns
30. Musculoskeletal Trauma and Nontraumatic Fractures
31. Head Trauma
,32. Spinal Injury and Spine Motion Restriction
33. Eye, Face, and Neck Trauma
34. Chest Trauma
35. Abdominal and Genitourinary Trauma
36. Multisystem Trauma and Trauma in Special Patient Populations
PART 11: SPECIAL PATIENT POPULATIONS
37. Obstetrics and Neonatal Care
38. Patients with Special Challenges
39. The Combat Veteran
PART 12: EMS OPERATIONS
40. Ambulance Operations and Air Medical Response
41. Gaining Access and Patient Extrication
42. Hazardous Materials
43. Multiple-Casualty Incidents and Incident Management
44. EMS Response to Terrorist Incidents and High Threat and Active Shooter Incidents
APPENDICES
1. ALS-Assist Skills
2. Advanced Airway Management
3. Agricultural and Industrial Emergencies
, Test Bank For Prehospital Emergency Care, 12th
Edition.(Mistovich Et Al.)(All Chapters Complete
Chapter 1 Emergency Care Systems, Research, And Public Health
1) What is a primary purpose of the modern-day ems system?
A) Provide a means of transport to and from the hospital
B) Ensure that all members of society have equal access to hospitals
C) Decrease the incidence of death and disability related to injury and illness
D) Provide emergency health care services to medically underserved
areas
Answer: c
Diff: 2 page ref: 7
Objective: 1-2
2) Most authorities agree that the modern-day ems system evolved after the release of
which document?
A) The emergency medical services act of 1973
B) The white paper "accidental death and disability: the neglected disease of
modern society" in 1966
C) The american heart association's guidelines for cardiac resuscitation
D) Emergency medical services: agenda for the future, in
1996
Answer: b
Diff: 1 page ref: 3
Objective: 1-2
3) An emergency medical responder comes to you and states that he would like to work for
your emergency ambulance service on a full-time basis. Knowing the national ems scope of
practice model, you inform him of which element?
A) He will be able to take care of only patients with non-life-threatening complaints
B) He will first need approval from your ambulance service's medical director
C) He will be able to work only with an advanced emt or paramedic
D) He will first have to become an emergency medical
technician answer: d
Diff: 1 page ref: 6-7
Objective: 1-1
4) As defined by the national ems scope of practice model, the four levels of ems
practitioners include:
A) Ambulance drivers
B) Ems medical director
C) Paramedics
D) Emergency medical
dispatchers
,Answer: c
Diff: 1 page ref: 6-7
Objective: 1-3
5) An emergency medical responder (emr) approaches you and states that he is interested in
becoming an emt. Specifically, he asks what he will be able to do as an emt that he cannot
presently do as an emr. You respond by saying he will be able to:
A) Administer some medications
B) Assist in emergency childbirth
C) Use an automated external defibrillator
D) Obtain vital
signs answer: a
Diff: 1 page ref: 6-7
Objective: 1-5
6) You have been dispatched for a 61-year-old female in cardiac arrest. Emergency medical
responders (emrs) are on scene. In your community, all ems practitioners are trained
according to the national ems scope of practice model. Given this, which type of care do you
expect the emrs to be providing?
A) Emergency medication administration
B) Automated external defibrillation
C) Intravenous therapy
D) Reading an
electrocardiogram answer: b
diff: 2 page ref: 6
Objective: 1-5
7) An emt with your service states that she desires to become a paramedic because she wants
to provide advanced care. Under the national ems scope of practice model, which one of these
types of care will she be able to provide as a paramedic that she cannot provide as an emt?
A) Automated blood pressure monitoring
B) Assistance with emergency childbirth
C) Interfacility transports
D) Iv
Therapy
Answer: d
Diff: 1 page ref: 7
Objective: 1-5
8) Which statement made by an emt requires immediate intervention by a superior or the
service supervisor?
A) "i always wear my seat belt whenever i am in the patient compartment of the
ambulance, unless i have to remove it to care for a patient."
B) "i drive as fast as i can to get to the scene of an emergency, especially if a child is
sick or injured according to dispatch information."
C) "when i am driving with lights and sirens, i instruct my partner that he will need to
,Handle all radio communications."
D) "i put exam gloves on for every patient i contact, even if he or she does not have a known
or suspected infectious disease."
Answer: b
Diff: 1 page ref: 9
Objective: 1-7
9) Which statement shows that the emt has a good understanding of her role
and responsibilities related to being an emt?
A) "the patient's needs come before anyone else's needs."
B) "at the scene of an emergency, my responsibility is to get to the patient no matter what."
C) "my safety comes first, and then the patient's safety."
D) "as an emt, i recognize that the public's safety comes before the safety of me or
my partner."
Answer: c
Diff: 2 page ref: 8-9
Objective: 1-7
10) An ambulance with two emts arrives in front of a house for an unknown medical
emergency. On scene, bystanders report that a female patient was beaten by her husband in the
driveway and then dragged back into the house. They state that the patient appeared
unconscious and was bleeding from the head. Which action would the emts perform next?
A) Do not enter the scene until it has been controlled by law enforcement
B) Quietly enter the home and quickly move the patient to the ambulance
C) Remove the husband from the house, then provide emergency care to the wife
D) Enter the home to protect the patient while waiting for the police to arrive
answer: a
Diff: 2 page ref: 9
Objective: 1-7
11) Why is ems in a unique position to contribute significantly to mobile integrated health care?
A) Ems providers are familiar with and capable of functioning in the out-of-
hospital environment
B) Ambulances are easily identified
C) The community trusts uniformed health care providers
D) Ems providers are familiar with the many routes of medication
administration answer: a
Diff: 1 page ref: 17
Objective: 1-15
12) You have arrived on the scene of a motor vehicle collision. A car has gone off the road
and into a utility pole. The pole is broken and wires are hanging just above the car. You do
not see any sparking or arcing of the wires. The driver of the car is slumped over the steering
wheel and not moving. Several bystanders around the car are yelling for you to help. Which
steps represent the correct order of your response?
A) Clear the bystanders, allow the fire department to secure the wires, access the patient,
extricate the patient, transport
,B) Access the patient, clear the bystanders, allow the fire department to secure the
wires, extricate the patient, transport
C) Clear the bystanders, access the patient, extricate the patient, transport, allow the
fire department to secure the wires
D) Access the patient, allow the fire department to secure the wires, clear the
bystanders, extricate the patient, transport
Answer: a
Diff: 2 page ref: 8-9
Objective: 1-7
13) Once a scene is free of safety hazards, the emt must recognize and focus on the needs of
the:
A) Rescuers
B) Patient
C) Family
D) Bystanders
Answer: b
Diff: 1 page ref: 9
Objective: 1-7
14) You have been asked to sit on your service's quality improvement (qi) committee. As a
knowledgeable emt, you recognize that in this role you will be involved in projects that are
primarily designed to:
A) Communicate with insurance companies for increased reimbursement
B) Recruit and educate emts about the emergency medical services profession
C) Develop ways in which the delivery of emergency care can be improved
D) Identify and reeducate emts who routinely do not provide proper care
answer: c
Diff: 2 page ref: 13
Objective: 1-10
15) What would be a logical project to be undertaken and developed by a quality
improvement (qi) committee?
A) Termination of emts who are chronically late to work
B) A program by which pay raises are based on performance and attitude
C) Community fundraiser to raise money for new ems equipment
D) Monthly continuing education programs in which seldom-used skills are
practiced answer: d
Diff: 2 page ref: 14
Objective: 1-10
16) You are interviewing for the position of emt with a busy urban service. This morning
you are to meet with the service's medical director. You have been told that she likes it when
applicants ask questions about her role as the medical director. Related to her
responsibilities as medical director, which question is most appropriate?
A) "how do you determine the wages that the emts are paid?"
B) "how do you determine the number and location of ambulances within the system?"
C) "how often are the emergency care protocols updated?"
,D) "do you assign the daily chores that must be completed around the
stations?" answer: c
Diff: 2 page ref: 12
Objective: 1-9
17) To be a medical director of an ambulance service, which requirement must the
interested individual satisfy?
A) Licensed physician
B) Emergency physician with surgical experience
C) Physician who was a paramedic
D) Physician with a college degree in
ems answer: a
Diff: 1 page ref: 12
Objective: 1-9
18) As an emt, which requirement must be met so that you can provide routine and
emergency medical care to the sick and injured, as an extension of the medical director's
authority?
A) Prior medical experience
B) A service medical director
C) A knowledgeable partner
D) A safe driving
record answer: b diff:
1 page ref: 12
Objective: 1-9
19) It has been some time since you were involved in the care of a pediatric patient. You decide
to review the assessment and treatment basics that your medical director requires. To review
this information, which resource should you consult first?
A) Emergency medical responders
B) Reputable websites
C) Emergency department nurses
D) Service protocols
Answer: d
Diff: 1 page ref: 13
Objective: 1-9
20) Before the emt contacts medical direction for authorization to assist a patient with
shortness of breath in using her metered-dose inhaler, protocols state that the emt must first
attempt to provide relief by administering oxygen if the pulse oximeter reading is less than
94%. You recognize that the administration of oxygen is best described as a(n):
A) Standing order
B) On-line medical direction
C) Direct permission
D) Quality improvement
Answer: a
Diff: 2 page ref: 13
,Objective: 1-9
21) If a patient with chest pain takes a daily aspirin, your medical director wants the emt to
contact an emergency department physician first before administering additional aspirin. The
act of contacting the emergency department physician by phone or radio for permission to
administer additional aspirin is an example of:
A) Quality improvement
B) On-line medical direction
C) Off-line medical direction
D) Indirect medical
control answer: b
diff: 2 page ref: 13
Objective: 1-1
22) At the scene of a minor motor vehicle collision, you are attending to a female patient
who complains of head and neck pain. A crowd has gathered to watch the action. What
will the observing public most likely remember about the role ems portrayed?
A) The number of emergency vehicles that showed up
B) The color of the ambulances
C) If the emts were all wearing the same color uniforms
D) Emts who were yelling and cursing loudly at the fire department to hurry up and get
the patient out of the car
Answer: d
Diff: 2 page ref: 11
Objective: 1-8
23) You work in a community that has an "enhanced" 911 system. Given this, which is
true about such a system?
A) The physical location of the landline used to make the 911 call is displayed to the call taker
B) The ems system uses emts, advanced emts, and paramedics
C) The fire department responds simultaneously with ems
D) The total response time for ems will rarely exceed 9
minutes answer: a
Diff: 1 page ref: 5
Objective: 1-4
24) Which patient would most benefit from calling an enhanced 911 system from the
home phone?
A) Patient with chest pain
B) Patient with sudden onset of confusion
C) Patient requiring advanced medical care
D) Patient who cannot reach the
phone answer: b
Diff: 2 page ref: 5
Objective: 1-4
, 25) A 14-year-old boy has fallen through a plate glass window and is bleeding heavily from a
laceration to his arm. His panicked mother has called 911 for help. Since the 911 operators
are also emergency medical dispatchers, what sort of assistance will they be able to provide?
A) Simultaneous notification of the hospital
B) Whether the ems response is covered by medical insurance
C) Instructions on how to control bleeding
D) The names of the emts who are
responding answer: c
Diff: 2 page ref: 5
Objective: 1-3
26) Which be an ems public health initiative?
A) Educating the public on the benefit of wearing seat belts
B) Volunteering time to help raise money for a sick child and his family
C) Providing volunteer emergency ambulance service 24 hours a day, 7 days a week
D) Purchasing new equipment to better help those persons who experience a medical
emergency answer: a
Diff: 2 page ref: 16
Objective: 1-14
27) Your service's medical director would like to explore the idea of emts using special
transport ventilators when caring for patients who require assistance with their breathing.
When using an evidence-based medicine approach, what should you do first?
A) Go to a local hospital to see which kind of ventilators it uses
B) Contact vendors that sell ventilators and ask for price quotations
C) Select specific emts to conduct a field trial of particular ventilators
D) Search the medical literature for research related to this topic
answer: d
Diff: 2 page ref: 14
Objective: 1-13
28) You are by the side of a confused patient who has diabetes and a low blood sugar level.
You know that the patient needs orally administered sugar, so following your service's
guidelines, you call the physician on duty at the hospital emergency department and request
permission to administer it. This request is an example of:
A) Standing orders
B) On-line medical direction
C) Medical cooperation
D) Off-line medical
direction answer: b
diff: 1 page ref: 12
Objective: 1-1
29) Which statement about emergency medical services in the united states is true?
A) The ems system is controlled and governed by the national highway transport and safety
administration (nhtsa)
B) The federal government oversees all aspects of ems in the united states